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Targeted imaging of myocardial contrast echocardiography evaluation of acute rejection after heart transplantation and extent of experimental study

Author: DongJing
Tutor: ZhangPingYang
School: Nanjing Medical University
Course: Internal Medicine
Keywords: Targeted microbubbles Myocardial contrast echocardiography Leukocyte Heart transplantation Acute rejection
CLC: R654.2
Type: Master's thesis
Year: 2010
Downloads: 13
Quote: 0
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Abstract


Objective To investigate the leukocyte passive targeting myocardial contrast echocardiography imaging of acute rejection after heart transplantation and the degree of diagnostic value. Methods The rats were randomly divided into four groups, A group of fellow transplant, B, C, D0 group allograft. B, C group were three days from the day before transplantation intraperitoneal injection of cyclosporine A10mg · kg-1 · d-1, 3mg · kg-1 · d-1, A, D0 cyclosporin A treatment group was not . Successfully established a total of 36 rat abdominal heterotopic heart transplantation model, A, B, C group of the eight cases, D0 group of 12 patients. 3 days after the SonoVue (SonoVue) continuous infusion via the jugular vein in rats, the application of ultrasound imaging technique to observe cardiac heterotopic heart transplantation, respectively, to obtain the injection of contrast agent 20 seconds myocardial perfusion images and 5 minutes WBC passive targeting myocardial contrast images were measured using an image analyzer gray scale value of its contrast (GS20s, GS5m). Targeting gray value (GStarget) for the same rats in GS5m and GS20s difference. After each observation the rats were sacrificed for pathological examination, HE staining to determine cardiac transplant rejection level, immunohistochemistry myocardial tissue transplantation CD3 T cell infiltration, and with each of the groups GS20s, GS5m, GStarget do correlation analysis. Results 1, WBC passive targeting myocardial contrast echocardiography evaluation of acute rejection after heart transplantation: the A group (control group) and D0 group (experimental group) ultrasound imaging and pathological analysis of the results shows: Myocardial perfusion imaging showed that the experimental group GS20s slightly lower than the control group GS20s (43.9 ± 3.2 vs 46.1 ± 3.3, P gt; 0.05), but the difference was not statistically significant. WBC passive targeting myocardial contrast showed that the experimental group was significantly higher GS5m GS5m (64.1 ± 3.1 vs 49.2 ± 3.6, P lt; 0.001), and GStarget experimental group was significantly higher (20.2 ± 4.0 vs 3.1 ± 1.5, P lt; 0.001). HE staining transplanted cardiomyocytes display control group mostly normal myocardial tissue, while the experimental group myocardial mostly grade Ⅲ ~ Ⅳ rejection, immunohistochemical analysis showed CD3 cell count of the experimental group than in the control group was significantly higher (30 ± 5 vs 2 ± 1 , P lt; 0.001), correlation analysis showed that: the experimental group and GStarget CD3 cell count was positively correlated (r = 0.79, P lt; 0.001). 2, WBC passive targeting myocardial contrast echocardiography after heart transplantation was observed varying degrees of acute rejection: D0 group were randomly selected from 8 cases of group D, and A, B, C group controlled study found that: myocardial perfusion imaging showing the GS20s no significant difference between groups (P gt; 0.05). Passive targeting leukocyte imaging showed gradient exists between the groups GS5m (P lt; 0.05), and each group GStarget significant difference between (P lt; 0.001). Pathology tests showed group A grade 0 ~ Ⅰ rejection, B group is displayed as myocardial rejection grade Ⅰ ~ Ⅱ, C group Ⅱ ~ Ⅲ rejection, D group of grade Ⅲ ~ Ⅳ rejection, immunohistochemical analysis showed CD3 cell count from group A to D group gradually increased, correlation analysis showed that: CD3 cell count and GStarget was positively correlated (r = 0.86, P lt; 0.001), correlated with GS5m, no meaningful correlation with GS20s . Conclusion Myocardial contrast echocardiography leukocyte passive targeting non-invasive technology, effective evaluation of acute rejection after heart transplantation and the extent of reaction.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Heart
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