Episode 27 Cardiac Stem CellsThis podcast features an interview by Bronwyn Cleary with Dr Magdelena Kostkiewiczat the EANM.The Role of Nuclear Imaging in Evaluating Myocardial Homing of Progenitor Cells and the Impact of Stem Cell Therapy on Myocardial Perfusion and Function.Background:In patients after myocardial infarction, stem cell therapy has already shown some clinical promise; however, many fundamental questions remain unanswered. The aim of this study was to evaluate the myocardial viability prior to stem cell transfer and its long-term effect on myocardial perfusion and function. In addition, early myocardial retention of tracer-labeled cells was evaluated.Material and methods:46 patients with a large anterior myocardial infarction (peak CK 2399-11213U/L, peak Tn I 68-249 ng/dL) were included in the study 6-9 days after primary PCI. The control group involved 12 patients not subjected to cell therapy (1:4 assignment). To evaluate myocardial perfusion and viability, regional and global left ventricular contractility, GSPECT was performed 2 days prior to autologous CD34+ cells’ transcoronary application. In addition, in a subgroup of 23 consecutive patients the cells were labeled with 99mTc-HMPAO to assess their early myocardial retention (i.e., homing to the infarct zone vs. border zone vs. non-infarcted area, myocardial SPECT) and proportion of retention in the heart vs. other organs (whole body SPECT). After 6 months, GSPECT was repeated.Results.In the impaired segments, improvement in both perfusion and ejection (global, regional) fraction was observed at 6 months (45- 49 % in the active group, 52-54% in controls). One hour after transcoronary transfer, 4.72 (1.45-8.42)% activity was detected in the myocardium. In 87% patients there was a clear border-zone engraftment, without any detectable retention in the no-perfusion zone. There was a correlation between peak TnI (but not cell number) and early engraftment efficiency (r=0.54, p=0.052).Conclusions; Our preliminary results support the hypothesis that, in patients with a large myocardial infarction, transcoronary implantation of autologous CD34+ cells stem cells has an impact on myocadial perfusion and function at 6 months. However, preferential engraftment of the (viable) border zone indicates that the area of ‘irreversible’ injury (no-perfusion zone) may not be accessible to transcoronary-delivered cells.Take the Quiz on episode 17 andTake the Quiz on episode 18 free.Also I have updated our links and you can get the podcast page at both http://nuccast.comAnd http://www.nuccast.com with the feed to put into iTunes or juice or your favorite podcast software can be found at http://molcast.com or http://www.molcast.com. The cardiac subset of the podcast can be found at http://cardiac.nuccast.com and the feed at http://cardiac.molcast.com.You can get text of the podcasts fromPodzingerPlease pass on information about this podcast to your colleagues and to your CPD provider.Remember you can get the podcast but going to itunes and entering the search term nuclear medicine best the way to subscribe is via this linkOr you can subscribe by entering your email address below and you will be informed of new episodesEnter your email address:Delivered by FeedBurnerThe easiest way to remember to tell your colleagues about the podcast is via the web link at nuccast.com or molcast.comMost importantly of all please help this podcast by contributing your opinions, Sound files, emails or phone calls details below:You click on the little bird icon below and it will allow you to send me a voice mail from your computer.If you don’t have a microphone then you can1. Call toll-free anytime 24/7 in the USA at 1-888-65-GCAST (888-654-2278). If outside USA: +1-305-437-8719.2. Enter the phone number 207-099-2527then enter the PIN 14013. Record your message, don’t worry it wont go straight into the podcast unless you ask me too.Please leave your name and email address in your message so I can get back to you.You can email me at rob@nuccast.comOrnucmedpodcast@gmail.comAll contributions welcome, especially as sound files to nucmedpodcast@gmail.com.Link link to mp3 fileDirect link to itunes 

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