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Autologous skeletal myoblast transplantation for severe postinfarction left ventricular dysfunction
Philippe Menasché1, Albert A Hagège, Jean-Thomas Vilquin
1Assistance Publique-Hôpitaux de Paris, Department of Cardiovascular Surgery B, Hôpital Bichat, Paris, France. philippe.menasche@hop.egp.ap-hop-paris.fr
Journal of the American College of Cardiology
|April 8, 2003
Summary
Autologous skeletal myoblast transplantation is a feasible and safe option for severe ischemic cardiomyopathy. This cell therapy improved heart function and reduced symptoms, though arrhythmogenic potential requires further study.
Area of Science:
- Cardiology
- Regenerative Medicine
- Cell Therapy
Background:
- Myoblast grafting into myocardial scars can improve left ventricular function post-infarction.
- Severe ischemic cardiomyopathy significantly impairs cardiac function.
Purpose of the Study:
- To assess the feasibility and safety of autologous skeletal myoblast transplantation in patients with severe ischemic cardiomyopathy.
- To evaluate the impact of this cell therapy on cardiac function and clinical outcomes.
Main Methods:
- A phase I trial involving ten patients with severe left ventricular dysfunction (ejection fraction ≤ 35%) and nonviable myocardial scars.
- Autologous skeletal myoblasts were cultured from thigh biopsies and transplanted during coronary bypass surgery.
- Assessment included dobutamine echocardiography and 18-fluorodeoxyglucose positron emission tomography to identify viable scar tissue.
Main Results:
- An average of 871 x 10^6 cells were implanted successfully.
- No deaths were directly related to cell transplantation; one patient had an early unrelated death.
- Average follow-up of 10.9 months showed improved New York Heart Association functional class (2.7 to 1.6) and ejection fraction (24% to 32%).
- Echocardiography revealed improved systolic thickening in 63% of cell-implanted scars.
Conclusions:
- Autologous skeletal myoblast transplantation appears feasible and safe for severe ischemic cardiomyopathy.
- The procedure demonstrated functional efficacy, with improved cardiac function and reduced symptoms.
- An arrhythmogenic potential was noted, necessitating further investigation in randomized studies.