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Updated: Mar 15, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
The extracellular matrix patch implanted in the right ventricle evaluated with cardiovascular magnetic resonance
Akiko Tanaka1, Keigo Kawaji2, Amit R Patel2
1Section of Cardiac and Thoracic Surgery, Department of Surgery, The University of Chicago, Chicago, IL, USA.
Objectives:
An extracellular matrix patch was implanted in the porcine right ventricle for in situ myocardial regeneration. A newly developed cardiovascular magnetic resonance protocol was utilized to investigate the regional physio-mechanical function of the patch.
Methods:
Cardiovascular magnetic resonance was performed at 60-day after the porcine right ventricular wall full thickness substitution with an extracellular matrix cardiac patch (n = 5). Dacron patches and remote normal right ventricle served as control (n = 5/each). Late gadolinium enhancement, strain encoding and rest perfusion were measured for scar/patch detection, regional contractility and tissue perfusion. Image analyses were performed by two observers to validate interobserver reproducibility.
Results:
All imaging sequences were successfully obtained. The patches were located with late gadolinium enhancement imaging in 95% accuracy. All the parameters demonstrated significant differences among extracellular matrix, Dacron and normal myocardium (P < 0.05), which correlated with histological findings, including constructive remodelling with nascent myocardium and profound vasculogenesis/angiogenesis in extracellular matrix patches, and scar formation in Dacron. Bland-Altman analysis demonstrated good interobserver reproducibility with minimal bias (strain encoding/peak strain: mean difference = -0.32%, 95% limits of agreement = -1.2 to 0.57, correlation = 0.97; rest perfusion/relative maximum upslope: mean difference = -0.74, 95% limits of agreement = -2.0 to 0.53, correlation = 0.92), along with excellent correlation obtained from linear regression (strain encoding: R2 = 0.93; rest perfusion: R2 = 0.85).
Conclusions:
With the cardiovascular magnetic resonance protocol, we successfully confirmed early signs of functional myocardial regeneration in implanted extracellular matrix patches. This approach is promising in assessing in situ regional physio-mechanical properties and degree of regeneration of implanted tissue-engineered materials.
