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May 13 -Molecular Imaging Reveals Heart Healing

PET and SPECT may allow expanded circulating progenitor cell (CPC) heart treatment and aid the selection of candidates who are likely to benefit from it. Researchers in Germany were able to observe the repair action of CPCs, immature, blood-derived cells capable of developing into adult stem cells, as they successfully preserved healthy heart tissue and corrected blood flow imbalance within the heart. The study was reported in the April issue of the Journal of Nuclear Medicine.

"PET and SPECT are the only techniques capable of validating the metabolic changes we needed to observe in the heart once we had administered the progenitor cells," says Kai Kendziorra, MD, a specialist in nuclear medicine at the University of Leipzig in Leipzig, Germany. "The results shown by these imaging modalities provide the evidence needed to expand the use of CPC treatment."

Twenty-six patients took part in the randomized, placebo-controlled, and double-blinded study. Following the recanalization of blocked coronary arteries (the surgical reopening or formation of new paths for blood flow), one group received an infusion of progenitor cells. FDG-PET and 99mTc-tetrofosmine-SPECT were then used to image relative changes in myocardial perfusion and glucose metabolism. The results were compared with a control group that had undergone recanalization but did not receive CPCs. In the CPC group, normalization of glucose metabolism and coronary blood flow was seen in nearly 50% of the repaired artery segments.

Earlier research has shown that when a patient's progenitor cells are activated by growth factors, the result is increased cell division, which is vital to the tissue repair process. In this study, progenitor cells developed from circulating blood were also found to be capable of repairing dysfunctional—yet viable—myocardial tissue, a condition referred to as "hibernating myocardium." Kendziorra believes that in addition to assisting in monitoring and guiding treatment of heart patients, PET scans may also be helpful in selecting those who would profit the most from CPC administration.

"Early detection of hibernating myocardial tissue via noninvasive imaging modalities such as PET and SPECT will help us to assess a patient's myocardial metabolism and blood flow," he says. "Subsequent early coronary recanalization and CPC administration may lead to treatment-specific normalization and reduce the risk of cardiac events over longer periods."

Source: Society of Nuclear Medicine

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