Objective: To evaluate the therapeutic effects of stem cell transplantation in heart failure patients with old myocardial infarction (OMI) by MRI.
Methods: Heart failure patients [NYHA 2.7 +/- 0.7, male = 18, mean age (59.5 +/- 10.1) y] with OMI were randomly divided into 2 groups (group A: CABG + stem cell transplantation, group B: CABG; n = 10 each). Left ventricular (LV) function was measured by MRI, viable myocardium was detected by (18)F-FDG myocardial metabolism imaging and late contrast-enhanced at baseline and 6 months post intervention.
Results: LVEF and LVEDV at baseline for group A were (20.71 +/- 6.09)% and (172.73 +/- 32.74) ml, and for group B were (27.59 +/- 2.31)% and (155.13 +/- 28.36) ml, respectively (P > 0.05). The LVEF was equally improved in group A and B (mean 8.63% vs. 10.37%, P > 0.05) while DeltaLVEDV was significant higher in group A than that in group B [(9.91 +/- 39.50) ml vs. (-22.34 +/- 31.35) ml, P < 0.05]. Ventricular wall thickening ratio at 6 months post intervention was significantly higher in group A than that in group B [(11.40 +/- 11.53)% vs. (2.27 +/- 7.20)%, P < 0.05]. Late contrast-enhanced MRI results correlated with (18)F-FDG myocardial metabolism imaging SPECT well in assessment of myocardial viability (kappa value: 0.446, P < 0.001; sensitivity: 68.3% and specificity: 92.5%).
Conclusions: Stem cell therapy on top of CABG aggravated LV remodeling in heart failure patients with old myocardial infarction. The specificity of MRI is similar to (18)F-FDG SPECT while the sensitivity is inferior to (18)F-FDG SPECT on detecting viable myocardium.