Autologous intramyocardial injection of cultured skeletal muscle-derived stem cells in patients with non-acute myocardial infarction
Jesús Herreros (a), Felipe Prósper (b), Ana Pérez (b), Juan J. Gavira (a), María José García-Velloso (c), Joaquín Barba (a), Pedro L. Sánchez (e), Consuelo Cañizo (d), Gregorio Rábago (a), Josep M. Martí-Climent (c), Milagros Hernández (b), Natalia López-Holgado (d), José María González-Santos (e), Cándido Martín-Luengo (e), Eduardo Alegría (a)
(a) Department of Cardiology and Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
(b) Hematology and Cell Therapy Area, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
(c) Department of Nuclear Medicine, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain.
(d) Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca, Spain.
(e) Department of Cardiology and Cardiac Surgery, Hospital Clínico Universitario de Salamanca, Salamanca, Spain.
Experimental animal studies suggest that the use of skeletal myoblast in patients with myocardial infarction may result in improved cardiac function. The aim of the study was to assess the feasibility and safety of this therapy in patients with myocardial infarction.
METHODS AND RESULTS
Twelve patients with old myocardial infarction and ischaemic coronary artery disease underwent treatment with coronary artery bypass surgery and intramyocardial injection of autologous skeletal myoblasts obtained from a muscle biopsy of vastus lateralis and cultured with autologous serum for 3 weeks. Global and regional cardiac function was assessed by 2D and ABD echocardiogram. 18F-FDG and 13N-ammonia PET studies were used to determine perfusion and viability. Left ventricular ejection fraction (LVEF) improved from 35.5+/-2.3% before surgery to 53.5+/-4.98% at 3 months (P=0.002). Echocardiography revealed a marked improvement in regional contractility in those cardiac segments treated with skeletal myoblast (wall motion score index 2.64+/-0.13 at baseline vs 1.64+/-0.16 at 3 months P=0.0001). Quantitative 18F-FDG PET studies showed a significant (P=0.012) increased in cardiac viability in the infarct zone 3 months after surgery.
No statistically significant differences were found in 13N-ammonia PET studies. Skeletal myoblast implant was not associated with an increase in adverse events. No cardiac arrhythmias were detected during early follow-up.
In patients with old myocardial infarction, treatment with skeletal myoblast in conjunction with coronary artery bypass is safe and feasible and is associated with an increased global and regional left ventricular function,improvement in the viability of cardiac tissue in the infarct area and no induction of arrhythmias.
CITATION Eur Heart J. 2003 Nov;24(22):2012-20