• Title/Summary/Keyword: Myocardial viability

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One-stop Evaluation Protocol of Ischemic Heart Disease: Myocardial Fusion PET Study (허혈성 심장 질환의 One-stop Evaluation Protocol: Myocardial Fusion PET Study)

  • Kim, Kyong-Mok;Lee, Byung-Wook;Lee, Dong-Wook;Kim, Jeong-Su;Jang, Yeong-Do;Bang, Chan-Seok;Baek, Jong-Hun;Lee, In-Su
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.33-37
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    • 2010
  • Purpose: In the early stage of using PET/CT, it was used to damper revision but recently shows that CT with MDCT is commonly used and works well for an anatomical diagnosis. This hospital makes the accuracy and convenience more higher in the diagnosis and evaluate of coronary heart disease through concurrently running myocardial perfusion SPECT examination, myocardial PET examination with FDG, and CT coronary artery CT angiography(coronary CTA) used PET/CT with 64-slice. This report shows protocol and image based on results from about 400 coronary heart disease examinations since having 64 channels PET/CT in July 2007. Materials and Methods: An Equipment for this examination is 64-slice CT and Discovery VCT (DVCT) that is consisted of PET with BGO ($Bi_4Ge_3O_{12}$) scintillation crystal by GE health care. First myocardial perfusion SPECT with pharmacologic stress test to reduce waiting time of a patient and get a quick diagnosis and evaluation, and right after it, myocardial FDG PET examination and coronary CTA run without a break. One-stop evaluation protocol of ischemic heart disease is as follows. 1)Myocardial perfusion SPECT with pharmacologic stress: A patient is injected with $^{99m}Tc$-MIBI 10 mCi and does not have any fatty food for myocardial PET examination and drink natural water with ursodeoxcholic acid 100 mg and we get SPECT image in an hour. 2)Myocardial FDG PET: To reduce blood fatty content and to increase uptake of FDG, we used creative oral glucose load using insulin and Acipimox to according to blood acid content. A patient is injected with $^{18}F$-FDG 5 mCi for reduction of his radiation exposure and we get a gated image an hour later and get delay image when we need. 3) Coronary CTA: The most important point is to control heart rate and to get cooperation of patient's breath. In order to reduce a heart rate of him or her below 65 beats, let him or her take beta blocker 50 mg ~ 200 mg after a consultation with a doctor about it and have breath-practices then have the examination. Right before the examination, we spray isosorbide dinitrate 3 to 5 times to lower tension of bessel wall and to extension a blood wall of a patient. It makes to get better the shape of an anatomy. At filming, a patient is injected CT contrast with high pressure and have enough practices before the examination in order to have no problem. For reduction of his radiation exposure, we have to do ECG-triggered X-ray tube modulation exposure. Results: We evaluate coronary artery stenosis through coronary CTA and study correlation (culprit vessel check) of a decline between stenosis and perfusion from the myocardial perfusion SPECT with pharmacologic stress, coronary CTA, and can check viability of infarction or hibernating myocardium by FDG PET. Conclusion: The examination makes us to set up a direction of remedy (drug treatment, PCI, CABG) because we can estimate of effect from remedy, lesion site and severity. In addition, we have an advantage that it takes just 3 hours and one-stop in that all of process of examinations run in succession and at the same time. Therefore it shows that the method is useful in one stop evaluation of ischemic heart disease.

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Effects of Sujeom-san Water Extract in Cultured Rat Myocardial Cells (수념산 전탕액이 배양 심근세포에 미치는 영향)

  • Jean Young Seok;Kwon Kang Beam;Park Eun Young;Soong Eun Kyung;Park Seung Taeck;Ryu Do Gon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.353-358
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    • 2002
  • To test the protective effect of herbal medicine against oxygen free radical-induced myocardiotoxicity, cytotoxicity of xanthine oxidase/hypoxanthine (XO/HX) was examined using MTT, TBARS, and beating rate assay in the presence of water extract of Sujeom-san(SJS) or single consituents of its prescription. Myocardial toxicity was evaluated in neonatal rat myocardiocytes in cultures. In the present paper, XO/HX resulted in a decrease in viability and beating rate and increases in lipid peroxidation in cultured myocardial cells. In the effect of SJS water extract, it showed effects from the cardiocytotoxicity induced by XO/HX treatment such as increases in beating rate and decreases in lipid peroxidation. In the effect of Rhizoma Corydalis (RC), Faeces Trogopterori (FT), Fructus Amomi Tsaoko (FAT) and Myrrha on the cardiocytotoxicity, they were significantly effective in blocking the XO/HX-induced cardiocytotoxicity by increase of beating rate in FAT and FT group as well as decrease of lipid peroxidation in FT and RC group. These results show that oxygen free radical elicits toxic effects in cultured myocardial cells derived from neonatal rat, and suggest that water extract of Sujeomsan, Rhizoma Corydalis, Faeces Trogopterori, Fructus Amomi Tsaoko or Myrrha is very effective in the prevention of xanthine oxidase/hypoxanthine- induced cardiotoxicity.

Comparative Study of the Magnetic Resonance Imaging in Myocardial Infarction model (심근경색 모델에서 자기공명영상에 대한 비교 연구)

  • Lim, Cheong-Hwan;Jung, Hong-Ryang;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.24 no.2
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    • pp.19-22
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    • 2001
  • The purpose of this study is to evaluate time course of signal enhancement on Gadomer-17 enhance MRI, and to correlate the size of enhanced area with that of the infarct area on 2'3'5'-triphenyl tetrazolium chloride(TTC) histochemical examination for the assessment of myocardial viability in reperfused Myocardial Infarction in a cat model. Tan cats(average weight: 3.8 kg) which had undergone 90 minutes of occlusion of the LAD followed by 90 minutes of reperfusion underwent MR T2-weighted imaging, and T1-weighted imaging, enhanced T1-weighted imaging. We used 1.5T Magneton Vision MRI system(Siemens, Erlangen, Germany). Signal intensities were measured in the enhanced and non-enhanced areas of enhanced T1-weighted imaging. and TTC histochemical staining the size of the abnormal signal area on each image was compared with that of the infarct area. Maximum enhancement was detected during a $40{\sim}60$ minute period with an average enhancement of $168{\pm}9.9%$ of normal myocardium. TTC staining revealed that the size of the high signal area on T2-weighted images and of the enhanced area on enhanced T1-weighted images was greater than that of the infarct area($T2=48.1%{\pm}3.7$, enhanced $T1=47.2%{\pm}2.6$, TTC $staining=38.7%{\pm}3.1$ ; p<0.05). In reperfused Myocardial Infarction in a cat model, enhanced MR imaging delineates reversibly and irreversibly damaged myocardium, with a strong enhancement and a broad temporal window. We may therefore expect that enhanced MR image is useful for demonstrating myocardial injury.

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Usefulness of contrast agent involving high gadolium content for myocardial viability assessment (심근생존능검사 시 가돌리늄 함유량이 높은 조영제의 유용성)

  • Choi, Kwan-Woo;Son, Soon-Yong;Kim, Tae-Hyung;Han, Man-Seok;Lee, Ju-Hee;Min, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1294-1300
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    • 2013
  • The purpose of this study is to increase contrast to noise ratio(CNR) in myocardial viability test by using contrast agent which highly content gadolinium(1mmol/mL) maximizing diagnostic value. This research method that four hundred four patients were underwent the MRI scanning two hundred eighty four of them were injected commercial contrast media which have 0.5mmol/L and the rest of them were injected new contrast media(gadobutrol) which have 1mmol/mL of molarity to study the contrast difference depending on the molarity of the contrast agent signal intensities of normal ventricle and left ventricle were measured to compare and evaluate signal to noise ratio(SNR) and CNR of the images. As result, 1mmol/mL contrast agent showed higher SNR by 25.13% in myocardium and 30.74% in left ventricle. CNR was proved to be better in 1mmol/mL contrast agent by 31.29%. The results above were all statistically meaningful. Therefore, contrast agent contenting more gadolinium which was 1mmol/mL in this study, could more effectively shorten T1 relaxation time, increase the signal intensity and at the same time maximize CNR and diagnostic value. This study firstly report the usefulness of 1mmol/mL contrast agent in patients allegedly suffering cardiac diseases and it is considered to increase diagnostic value.

Assessment of Viable Myocardium with Nuclear Imaging (핵의학 영상을 이용한 생존심근 평가)

  • Kang, Won-Jun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.203-206
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    • 2009
  • Nuclear cardiac imaging has been widely used to assess viable myocardium in patients with ischemic heart disease, The assessment of viable myocardium is important in selecting patients who will be benefit from revascularization. Although revascularization is indicated in patients with sufficient myocardium, patients with scar tissue should be treated medically. Nuclear imaging methods including myocardial perfusion SPECT and FDG PET have been shown to be effective modalities for identifying viable myocardium.

Accuracy of Ventricular Volume and Ejection Fraction Measured by Gated Tl-201 Perfusion Single Photon Emission Tomography (심전도 게이트 심근관류 Tl-201 SPECT로 측정된 좌심실 기능 및 좌심실 용적의 정확성)

  • Pai, Moon-Sun;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.94-99
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    • 2005
  • Electrocardiogram-gated single photon omission computed tomography (SPECT) provides valuable information in the assessment of both myocardial perfusion and ventricular function. Tl-201 is a suboptimal isotope for gating. Tl-201 images are more blurred compared with Tc-99m tracers due to the increased amount of scattered photons and use of a smooth filter. The average myocardial count densities are approximately one-half those of conventional technetium tracers. However, Tl-201 is still widely used because of its well-established utility for assessing myocardial perfusion, viability and risk stratification. Gated SPECT with Tl-201 enables us to assess both post-stress and rest left ventricular volume and function. Previous studies with gated Tl-201 SPECT measurements of ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) have shown high correlation with first-pass radionuclide angiography, gated blood pool scan, Tc-99m-MIBI gated SPECT, contrast ventriculography, echocardiography, and 3-dimensional magnetic resonance imaging. However, problems related to these studies include few agreement data of EDV and ESV, use of a reference method that is likely to have the same systemic errors (gated Tc-99m-MIBI SPECT), and other technical factors related to the count density of gated SPECT. With optimization of gated imaging protocols and more validation studies, gated Tl-201 SPECT would be an accurate method to provide perfusion and function information in patients with coronary artery disease.

Role of Rest Redistribution Imaging in T1-201 Reinjection Imaging Technique (탈륨 재주사영상법에서 휴식기재분포영상의 의의)

  • Bom, Hee-Seung;Song, Ho-Chun;Kim, Ji-Yeul;Jeong, Myung-Ho;Kang, Jung-Chaee
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.191-194
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    • 1993
  • Apparent washout of T1-201 may occur between redistribution and reinjection images. To examine the frequency of it, we prospectively compared 4-hour redistribution and reinjection images in 63 consequent patients. All patients underwent pharmacological stress test using 0.56 mg/kg dipyridamole. Immediately after the 4-hour redistribution images, 1 mCi T1-201 was injected at rest, and images were reacquired 10 minutes after reinjection. The stress, redistribution, and reinjection images were then analyzed semiquantitatively (0=no uptake, 1=faint uptake, 2=mildly diminished uptake, 3=normal uptake). Of the 100 abnormal myocardial regions on the stress images, 54 showed either complete or partial reversibility on 4-hour redistribution images. After reinjection 11(21.2%) of these regions demonstrated apparent T1-201 washout due to low differential uptake of the tracer. Such lesions would appear irreversible if redistribution imaging is not performed before reinjection. Thus 4-hour redistribution imaging should be performed for assessment of myocardial ischemia and viability.

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Transfection of Mesenchymal Stem Cells with the FGF-2 Gene Improves Their Survival Under Hypoxic Conditions

  • Song, Heesang;Kwon, Kihwan;Lim, Soyeon;Kang, Seok-Min;Ko, Young-Guk;Xu, ZhengZhe;Chung, Ji Hyung;Kim, Byung-Soo;Lee, Hakbae;Joung, Boyoung;Park, Sungha;Choi, Donghoon;Jang, Yangsoo;Chung, Nam-Sik;Yoo, Kyung-Jong;Hwang, Ki-Chul
    • Molecules and Cells
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    • v.19 no.3
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    • pp.402-407
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    • 2005
  • Bone marrow mesenchymal stem cells (MSCs) have shown potential for cardiac repair following myocardial injury, but this approach is limited by their poor viability after transplantation. To reduce cell loss after transplantation, we introduced the fibroblast growth factor-2 (FGF-2) gene ex vivo before transplantation. The isolated MSCs produced colonies with a fibroblast-like morphology in 2 weeks; over 95% expressed CD71, and 28% expressed the cardiomyocyte-specific transcription factor, Nkx2.5, as well as ${\alpha}$-skeletal actin, Nkx2.5, and GATA4. In hypoxic culture, the FGF-2-transfected MSCs (FGF-2-MSCs) secreted increased levels of FGF-2 and displayed a threefold increase in viability, as well as increased expression of the anti-apoptotic gene, Bcl2, and reduced DNA laddering. They had functional adrenergic receptors, like cardiomyocytes, and exposure to norepinephrine led to phosphorylation of ERK1/2. Viable cells persisted 4 weeks after implantation of $5.0{\times}10^5$ FGF-2-MSCs into infarcted myocardia. Expression of cardiac troponin T (CTn T) and a voltage-gated $Ca^{2+}$ channel (CaV2.1) increased, and new blood vessels formed. These data suggest that genetic modification of MSCs before transplantation could be useful for treating myocardial infarction and end-stage cardiac failure.

MiR-182-5p Mediated by Exosomes Derived From Bone Marrow Mesenchymal Stem Cell Attenuates Inflammatory Responses by Targeting TLR4 in a Mouse Model of Myocardial Infraction

  • Chuang Sun;Wei Li;Yanhong Li;Jian Chen;Huixian An;Guangwei Zeng;Tingting Wang;Yazhou Guo;Changying Wang
    • IMMUNE NETWORK
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    • v.22 no.6
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    • pp.49.1-49.15
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    • 2022
  • Exosomes derived from mesenchymal stem cells (MSCs) could protect against myocardial infarction (MI). TLR4 is reported to play an important role in MI, while microRNA-182-5p (miR-182-5p) negatively regulates TLR4 expression. Therefore, we hypothesize that MSCs-derived exosomes overexpressing miR-182-5p may have beneficial effects on MI. We generated bone marrow mesenchymal stem cells (BM-MSCs) and overexpressed miR-182-5p in these cells for exosome isolation. H2O2-stimulated neonatal mouse ventricle myocytes (NMVMs) and MI mouse model were employed, which were subjected to exosome treatment. The expression of inflammatory factors, heart function, and TLR4 signaling pathway activation were monitored. It was found that miR-182-5p decreased TLR4 expression in BM-MSCs and NMVMs. Administration of exosomes overexpressing miR-182-5p to H2O2-stimulated NMVMs enhanced cell viability and suppressed the expression of inflammatory cytokines. In addition, they promoted heart function, suppressed inflammatory responses, and de-activated TLR4/NF-κB signaling pathway in MI mice. In conclusion, miR-182-5p transferred by the exosomes derived from BM-MSCs protected against MI-induced impairments by targeting TLR4.