| Background: 18F-FDG and 99Tcm-MIBI dual-isotope simultaneous acquisition (DISA SPECT) may be useful or assessment of the survival myocardial with double information of myocardial perfusion and Metabo- lism at the same time. It was very important to assess first the feasibility and safety of autonomous bone marrow–derived mononuclear cell transp- lantation (BMCT) into the ischemic myocardium in patients who undergo coronary artery bypass surgery.Objective: To evaluate myocardial metabolism and perfusion with OMI after CABG and autonomous mononuclear bone marrow cell transplantati- on with 18F-FDG and 99Tcm-MIBI dual-isotope simultaneous acquisition on gated SPECTMethods: 20 patients with OMI were enrolled in this study and underw- ent 18F-FDG and 99Tcm-MIBI dual-isotopic imaging before and 4 months a- fter CABG and autonomous mononuclear bone marrow cell transplantation and divided into two groups: CABG alone (group A) and CABG+autonom- ous mononuclear bone marrow cell transplantation (group B). In group B, Bone marrow was harvested from the iliac crest one day before surgery, and purified autonomous mononuclear bone marrow cells and were injected in the infarct border zone during the CABG operation. Distributions of the 2 radiotracers in myocardial segments were divided into 9 segments and were classified into 2 patterns by the results of the before: myocardial perfusion–metabolism mismatch (MM) and match (M). The myocardial uptakes of99Tcm-MIBI and 18F-FDG were assessed using a 4-point scoring system to assess regional myocardial blood perfusion and glucose metabolism by 2 experienced observers, who were unaware of the clinical information. EF EDV ESV and SV were measured to investigate the global function.Results: In group A, Divide into 99 segments in 11 patients, in the 52 segments of the MM, 99Tcm–MIBI and 18F-FDG uptake fraction at 4 months after operation (1.75±0.68,2.13±0.74) was higher than at baseline (1.48±0.75,1.90±0.75), the difference both (P<0.01) were significant. In the 47 segments of M, 99mTc–MIBI and 18F-FDG uptake fraction was (1.70±0.66 1.89±0.63) at 4 months after operation and at baseline (1.64±0.70 1.87±0.54), the difference both (P>0.05) were not significant. In group B, Divide into 81 segments in 9 patients, in the 45 segments of the MM, 99mTc–MIBI and 18F-FDG uptake fraction at 4 months after operation (1.53±0.66,2.00±0.64) was higher than at baseline (1.24±0.68,1.71±0.76),the difference both(P<0.01) were significant. In the 36 segments of the M,99mTc–MIBI and 18F-FDG uptake fraction at 4 months after operation (1.22±0.76,1.78±0.64) was higher than at baseline (0.94±0.75,1.50±0.74),the difference both(P<0.05) were significant. EF and SV after operation(34.2±9.7%,58.81±27.1ml) was much higher than at baseline (28.5±9.4%,45.6±17.0ml),the difference (P<0.05) was significant. end-diastolic volume and end-systolic volume was 180±77ml,122±57ml after operation and was 168±64ml,124±54ml at baseline, the difference (P>0.05) was not significant.Conclusion: Coronary Artery Bypass Graft can improve the function of survival myocardial segments, but it was helpless to infraction myocardial; the autonomous mononuclear bone marrow cell transplantation can improve myocardial blood perfusion and glucose metabolism of the distributions of infracts myocardial. The best parameter was EF and SV to evaluate the global function.
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