EXPEDITED REVIEW
Magnetic resonance imaging of targeted catheter-based implantation of myogenic precursor cells into infarcted left ventricular myocardium
J.érôme Garot, MD, PhD*, ,1,*,
Thierry Unterseeh, MD*,,1,
Emmanuel Teiger, MD, PhD ,
Stéphane Champagne, MD*,,
B.énédicte Chazaud, PhD ,
Romain Gherardi, MD, PhD,
Luc Hittinger, MD, PhD*,,
Pascal Guéret, MD, FACC and
Alain Rahmouni, MD||
* INSERM U 400, Créteil, France
Fédération de Cardiologie, Créteil, France
Explorations Fonctionnelles and INSERM U492, Créteil, France
INSERM E00-11, Créteil, France
|| Département de Radiologie, Henri Mondor University Hospital, AP-HP, Créteil, France
Manuscript received March 4, 2003;
accepted March 12, 2003.
* Reprint requests and correspondence: Dr. Jérôme Garot, Fédération de Cardiologie, Hopital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
jgarot{at}free.fr
OBJECTIVES: This study was designed to test the hypothesis that myocardial implantation of myogenic precursor cells (MPC) loaded with iron oxide can be reliably detected in vivo by cardiac magnetic resonance imaging (MRI).
BACKGROUND: In vivo imaging of targeted catheter-based implantation of MPC into infarcted left ventricular (LV) myocardium is unavailable.
METHODS: The study was conducted in seven farm pigs (four with anterior myocardial infarction), in which autologous MPC were injected through a percutaneous catheter allowing for LV electromechanical mapping and guided micro-injections into normal and infarcted myocardium. Cardiac MRI was used to detect implanted MPC previously loaded with iron oxide nanoparticles.
RESULTS: Magnetic resonance imaging data were compared with LV electromechanical mapping and cross-registered pathology. All 9 injections into normal and 12 injections into locally damaged myocardium were detected on T2-weighted spin echo and inversion-recovery true-fisp MRI (low signal areas) with good anatomical concordance with sites of implantation on electromechanical maps. All sites of injection were confirmed on pathology that showed in all infarct animals iron-loaded MPC at the center and periphery of the infarct as expected from MRI.
CONCLUSIONS: Targeted catheter-based implantation of iron-loaded MPC into locally infarcted LV myocardium is accurate and can be reliably demonstrated in vivo by cardiac MRI. The ability to identify noninvasively intramyocardial cell implantation may be determinant for future experimental studies designed to analyze subsequent effects of such therapy on detailed segmental LV function.
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Abbreviations and Acronyms
| | Gd-DTPA | | gadolinium-enhanced diethlenetriaminepentaacetic acid | | IV | | intravenous | | LV | | left ventricular | | MPC | | myogenic precursor cells | | MRI | | magnetic resonance imaging |
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