東京女子医科大学循環器内科学，画像診断学・核医学分野 兼務・助教AbstractCardiac regeneration therapy (CRT) is a treatment option for patients with ischemic heart disease (IHD) and reduced ejection fraction (EF) who exhibit severe symptoms despite optimal medical and invasive therapy. CRT is expected as a promising alternative for patients who are ineligible for heart transplantation (HTx) and for whom ventricular assist device implantation is not feasible. In previous animal experiments, it was shown that cardiac function can be improved by implanting induced pluripotent stem (iPS) cardiomyoblasts, a type of CRT, into the hearts of myocardial infarction models. 13N-ammonia positron emission tomography (NH3-PET), with its superior temporal and spatial resolution. NH3-PET enables the evaluation of myocardial blood flow (MBF) and myocardial flow reserve (MFR). The integration of MFR with myocardial perfusion imaging (MPI) enhances the diagnostic accuracy for IHD and facilitates more refined risk stratification when combined with data from coronary CT angiography. Additionally, MFR is a significant prognostic indicator in individuals with IHD. We have reported that MFR can be used to visualize the improvement in myocardial blood flow due to myocardial regenerative medicine. In this study, we aimed to evaluate MFR obtained from NH3-PET before and after iPS transplantation and coronary artery bypass graft (CABG) surgery, and to investigate the therapeutic effect.We retrospectively analyzed three consecutive patients who underwent NH3-PET before and after iPS transplantation and CABG. We also analyzed 16 patients who underwent NH3-PET before and after CABG alone as a control group. We defined the change in MFR before and after surgery as ΔMFR and compared between the two groups. We also performed a subgroup analysis of patients with LVEF <30%.The iPS+CABG group had a ΔMFR of 0.60 (0.04-1.01), and trended to increase MFR compared to the CABG-only group, which had a ΔMFR of 0.4 (0.07-1.04). The difference was more pronounced in ptients with LVEF <30% (0.60 [0.04-1.01] vs. 0.17 [0.14-0.21]).山本 篤志Atsushi YamamotoTokyo Women's Medical University― 142 ―PETと人工知能による心筋再生医療に特化したRadiomics構築Evaluation of cardiac regeneration therapy using ammonia PET myocardial flow reserve
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