RT Journal Article SR Electronic T1 Scintigraphic Assessment of the Effects of Bone Marrow–Derived Mononuclear Cell Transplantation Combined with Off-Pump Coronary Artery Bypass Surgery in Patients with Ischemic Heart Disease JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1610 OP 1617 VO 46 IS 10 A1 Yaoita, Hiroyuki A1 Takase, Shinya A1 Maruyama, Yukio A1 Sato, Yoshiyuki A1 Satokawa, Hirono A1 Hoshi, Nobuo A1 Ono, Nobutaka A1 Igari, Tsuguo A1 Ohto, Hitoshi A1 Yokoyama, Hitoshi YR 2005 UL http://jnm.snmjournals.org/content/46/10/1610.abstract AB Myocardial SPECT may be useful for assessment of the therapeutic effects and the mechanisms of cardiac regeneration medicine. We aimed to assess first the feasibility and the short-term safety of autologous bone marrow–derived mononuclear cell transplantation (BMCT) into the ischemic myocardium in patients who undergo off-pump coronary artery bypass surgery (OPCAB). In addition, we aimed to assess our hypothesis that the BMCT may help ameliorate myocardial perfusion in patients with ischemic heart disease (IHD) using myocardial perfusion scintigraphy. Methods: We performed BMCT in 10 patients with IHD during OPCAB. Cells for BMCT were collected by intraoperative bone marrow aspiration or by preoperative cellular apheresis after pretreatment with granulocyte colony-stimulating factor. After OPCAB was performed in all graftable ischemic areas, a total of 3.4 ± 1.2 × 109 mononuclear cells, including 5.2 ± 1.6 × 106 CD34-positive (CD34+) cells, were injected into ungraftable ischemic myocardial areas. Dipyridamole-stress and resting 99mTc myocardial SPECT was performed before and 1 mo after the procedures. Results: BMCT was performed safely in all patients. Compared with before treatment, myocardial 99mTc tracer uptake on the dipyridamole-stress image increased similarly in BMCT- and OPCAB-treated areas, whereas tracer accumulation at rest did not change in all myocardial areas. The improvement of myocardial perfusion was not correlated with the total number of mononuclear cells transplanted. However, it was positively correlated with the number of transplanted CD34+ cells: 99mTc tracer uptake after/before BMCT (ratio) = 1.091 × (CD34+ cell number [×106])0.074 (r2 = 0.48, P < 0.05), although new development of coronary vessels was not documented cineangiographically. Myocardial histopathology in 2 of 3 autopsy cases revealed coronary angiogenesis in the areas corresponding to the sites of BMCT. Conclusion: The present study demonstrates the feasibility of BMCT combined with OPCAB. This therapy improves myocardial perfusion possibly via CD34-related development of coronary microvessels.