Factors affecting functional outcome after autologous skeletal myoblast transplantation.
BACKGROUND
This study assessed the extent to which the initial degree of functional impairment and the number of injected cells may influence the functional improvement provided by autologous skeletal myoblast transplantation into infarcted myocardium.


METHODS
One week after left coronary artery ligation, 44 rats received into the infarcted scar, autologous skeletal myoblasts expanded in vitro for 7 days (mean, 3.5 x 10(6), n = 21), or culture medium alone (controls, n = 23). Left ventricular function was assessed by two-dimensional echocardiography.


RESULTS
When transplanted hearts were stratified according to their baseline ejection fraction, a significant improvement occurred at 2 months in the less than 25% (from 21.4% to 37%), 25% to 35% (from 29% to 43.8%), and in the 35% to 40% (from 37.2% to 41.7%) groups, compared to controls (p = 0.048, 0.0057, and 0.034, respectively), but not in the more than 40% stratum. A significant linear relationship was found between the improvement in ejection fraction and the number of injected myoblasts, both at 1 and 2 months after transplantation (p < 0.0001).


CONCLUSIONS
Autologous myoblast transplantation is functionally effective over a wide range of postinfarct ejection fractions, including in the sickest hearts provided that they are injected with a sufficiently high number of cells.
Department of Cardiovascular Surgery, H pital Bichat, INSERM U523, Institut de Myologie, Paris, France.
B
B
Pouzet
J T
JT
Vilquin
A A
AA
Hagège
M
M
Scorsin
E
E
Messas
M
M
Fiszman
K
K
Schwartz
P
P
Menasché
D000818:Animals; D017690:Cell Transplantation; D008297:Male; D018482:Muscle, Skeletal / Q000166:cytology*; D009203:Myocardial Infarction / Q000628:therapy*; D051381:Rats; D017208:Rats, Wistar; D016896:Treatment Outcome