Purpose:To use magnetic resonance (MR) imaging and positron emission tomography (PET) dual detection of cardiacgrafted embryonic stem cells (ESCs) to examine (a) survival and proliferation of ESCs in normal and infarcted myocardium, (b) host macrophage versus grafted ESC contribution to serial MR imaging signal over time, and (c) cardiac function associated with the formation of grafts and whether improvement in cardiac function is related to cardiac differentiation of ESCs.
Materials and Methods:All animal procedures were approved by the institutional animal care and use committee. Murine ESCs were stably transfected with a mutant version of herpes simplex virus type 1 thymidine kinase, HSV1-sr39tk, and also were labeled with superparamagnetic iron oxide (SPIO) particles. Cells were injected directly in the border zone of the infarcted heart or in corresponding regions of normal hearts in athymic rats. PET and MR imaging were performed longitudinally for 4 weeks in the same animals.
Results:ESCs survived and underwent proliferation in the infarcted and normal hearts, as demonstrated by serial increases in 9-(4-[ 18 F]fluoro-3-hydroxymethylbutyl) guanine PET signals. In parallel, the hypointense areas on MR images at the injection sites decreased over time. Double staining for host macrophages and SPIO particles revealed that the majority of SPIO-containing cells were macrophages at week 4 after injection. Left ventricular ejection fraction increased in the ESC-treated rats but decreased in culture media-treated rats, and border-zone function was preserved in ESC-treated animals; however, cardiac differentiation of ESCs was less than 0.5%.
Conclusion:Dual-modality imaging permits complementary information in regard to cell survival and proliferation, graft formation, and effects on cardiac function. RSNA, 2009 Supplemental Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article.
Coronary heart disease accounts for 36% of all cardiovascular death and is the leading cause of heart failure in the United States (1). Although postinfarction survival rates have been improved, congestive heart failure caused by a large infarction or progressive unfavorable ventricular remodeling remains a major problem (2). Despite that cardiac transplantation is currently the most effective therapy, the disparity between organ demand and supply limits its applicability. A treatment strategy often referred to as "cellular cardiomyoplasty" is an attempt at cardiac repair through local (intramyocardial, intracoronary) or systemic (intravenous) delivery of a variety of cells, including fetal or neonatal cardiomyocytes, cardiac cells derived from adult atrial appendages, skeletal myoblasts, embryonic stem cells (ESCs), or bone marrow-derived mesenchymal and hematopoietic stem cells. The strategy is based on the potential of these cells to differentiate into cardiomyocytes to repopulate the ...