Computed Tomographic Assessment of Coronary Arteries in Patients Undergoing Stem Cell Therapy Following an Acute Myocardial Infarction

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Despite of numerous treatment strategies developed in the last years, ischemic heart disease remains the leading cause of death around the world. Acute myocardial infarction (MI) causes irreversible destruction to the myocardial tissue, which is replaced by fibroblast cells, leading to the formation of a dense, collagenous scar, a non-contractile tissue, and often to heart failure. Stem cell therapy seems to represent the next therapeutic method for the treatment of heart failure caused by myocardial infarction. Several international trials proved the beneficial outcome of the intracoronary infusion of bone marrow-derived stem cells, improving left ventricular systolic function and clinical symptomatology. Many noninvasive imaging procedures are available to evaluate the beneficial properties of stem cell therapy. Most studies have demonstrated the role of multislice computed tomography (MSCT) in evaluating left ventricular parameters such as end-diastolic and end-systolic volumes and ejection fraction, or to quantify myocardial scar tissue. In this review we will discuss the usefulness of MSCT for the assessment of coronary arteries, new tissue regeneration, and evaluation of tissue changes and their functional consequences in subjects undergoing stem cell treatment following MI.

1. Finegold JA, Asaria P, Francis DP. Mortality from ischaemic heart disease by country, region, and age: statistics from World Health Organisation and United Nations. Int J Cardiol. 2013;168:934-945.

2. Lauer MS. Advancing cardiovascular research. Chest. 2012;141:500-505.

3. Bergmann O, Bhardwaj RD, Bernard S, et al. Evidence for cardiomyocyte renewal in humans. Science. 2009;324:98-102.

4. Segers VF, Lee RT. Stem-cell therapy for cardiac disease. Nature. 2008;451:937-942.

5. Asahara T, Kalka C, Isner JM. Stem cell therapy and gene transfer for regeneration. Gene therapy. 2000;7:451-457.

6. Borlongan CV, Glover LE, Tajiri N, Kaneko Y, Freeman TB. The great migration of bone marrow-derived stem cells toward the ischemic brain: therapeutic implications for stroke and other neurological disorders. Progress in neurobiology. 2011;95:213-228.

7. Tendera M, Wojakowski W, Ruzyllo W, et al. Intracoronary infusion of bone marrow-derived selected CD34+ CXCR4+ cells and non-selected mononuclear cells in patients with acute STEMI and reduced ventricular ejection fraction: results of randomized, multicenter Myocardial Regeneration by Intracoronary Infusion of Selected Population of Stem Cells in Acute Myocardial Infarction (REGENT) Trial. Eur Heart J. 2009;30:1313-1321.

8. Meyer GP, Wollert CK, Lotz J, et al. Intracoronary bone marrow cell transfer after myocardial infarction: 5 year follow-up from the randomized-controlled BOOST trial. Eur Heart J. 2009;30:2978-2984.

9. Benedek I, Bucur O, Benedek T. Intracoronary Infusion of Mononuclear Bone Marrow-Derived Stem Cells is Associated with a Lower Plaque Burden After Four Years. J Atheroscle Thromb. 2013;21:216-229.

10. Wollert KC, Drexler H. Cell therapy for the treatment of coronary heart disease: a critical appraisal. Nat Rev Cardiol. 2010;7:204-215.

11. Lau JF, Anderson SA, Adler E, Frank JA. Imaging approaches for the study of cell-based cardiac therapies. Nat Rev Cardiol. 2010;7:97-105.

12. Beeres SL, Bengel FM, Bartunek J, et al. Role of imaging in cardiac stem cell therapy. J Am Coll Cardiol. 2007;49:1137-1148.

13. Amado LC, Saliaris AP, Schuleri KH, et al. Cardiac repair with intramyocardial injection of allogeneic mesenchymal stem cells after myocardial infarction. Proc Natl Acad Sci U S A. 2005;102:11474-1179.

14. Sayyed SH, Cassidy MM, Hadi MA. Use of multidetector computed tomography for evaluation of global and regional left ventricular function. J Cardiovasc Comput Tomogr. 2009;3:23-34.

15. Assmus B, Honold J, Schächinger V, et al. Transcoronary transplantation of progenitor cells after myocardial infarction. N Engl J Med. 2006;355:1222-1232.

16. Nyolczas N, Gyöngyösi M, Beran G, et al. Design and rationale for the Myocardial Stem Cell Administration After Acute Myocardial Infarction (MYSTAR) Study: a multicenter, prospective, randomized, single-blind trial comparing early and late intracoronary or combined (percutaneous intramyocardial and intracoronary) administration of non-selected autologous bone marrow cells to patients after acute myocardial infarction. Am Heart J. 2007;153:212.e1-e7.

17. Voros S. What are the potential advantages and disadvantages of volumetric CT scanning? J Cardiovasc Comput Tomogr. 2009;3:67-70.

18. Miller JM, Rochitte CE, Dewey M, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med. 2008;359:2324-2336.

19. Voros S, Rinehart S, Qian Z, et al. Coronary atherosclerosis imaging by coronary CT angiography: current status, correlation with intravascular interrogation and meta-analysis. JACC Cardiovasc Imaging. 2011;4:537-548.

20. Boogers MJ, Broersen A, van Velzen JE, et al. Automated quantification of coronary plaque with computed tomography: comparison with intravascular ultrasound using a dedicated registration algorithm for fusion-based quantification. Eur Heart J. 2012;33:1007-1016.

21. Budoff MJ, Shaw LJ, Liu ST, et al. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol. 2007;49:1860-1870.

22. Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA. 2004;291:210-215.

23. Arbab-Zadeh A, Fuster V. The Myth of the “Vulnerable Plaque”: transitioning from a focus on individual lesions to atherosclerotic disease burden for coronary artery disease risk assessment. J Am Coll Cardiol. 2015;65:846-855.

24. de Graaf MA, Broersen A, Kitslaar PH, et al. Automatic quantification and characterization of coronary atherosclerosis with computed tomography coronary angiography: cross-correlation with intravascular ultrasound virtual histology. Int J Cardiovasc Imaging. 2013;29:1177-1190.

25. de Feyter PJ, Nieman K. CCTA to guide revascularization for high-risk CAD: a “cliff hanger”. Eur Heart J. 2012;33:3011-3013.

26. Schuleri KH, Centola M, Choi SH, et al. CT for Evaluation of Myocardial Cell Therapy in Heart Failure. JACC Cardiovasc Imaging. 2011;4:1284-1293.

27. Schuleri KH, Feigenbaum GS, Centola M, et al. Autologous mesenchymal stem cells produce reverse remodelling in chronic ischaemic cardiomyopathy. Eur Heart J. 2009;30:2722-2732.

28. Quevedo HC, Hatzistergos KE, Oskouei BN, et al. Allogeneic mesenchymal stem cells restore cardiac function in chronic ischemic cardiomyopathy via trilineage differentiating capacity. Proc Natl Acad Sci U S A. 2009;106:14022-14027.

29. Amado LC, Schuleri KH, Saliaris AP, et al. Multimodality Noninvasive Imaging Demonstrates In Vivo Cardiac Regeneration After Mesenchymal Stem Cell Therapy. J Am Coll Cardiol. 2006;48:2116-2124.

30. Orlic D, Kajstura J, Chimenti S, et al. Bone marrow cells regenerate infarcted myocardium. Nature. 2001;410:701-705.

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