Cell transplantation in non-ischemic dilated cardiomyopathy. A novel biological approach for ventricular restoration.
OBJECTIVE
With a rising incidence, dilated cardiomyopathy (DCM) is regarded as a major health care concern. Although both medical therapy and novel surgical treatments have been applied to treat DCM, the effects of preventing left ventricular (LV) dilatation are limited, and the mortality rate associated with the disease remains high. Thus novel management strategies for improved treatment of DCM are awaited.


METHODS
Researchers have found that, in models of regional ventricular dysfunction, transplanted cells induced a profound biological phenomenon that restored contractile function and prevented ventricular dilatation. We have investigated muscle cell transplantation in hamsters with DCM, and have found that heart cells and smooth muscle cells survived in the host myocardium after transplantation, which suppressed LV dilatation and wall thinning, and preserved heart function. Our current studies are focusing on the clinical applicability of these encouraging early findings by evaluating the optimal cell types, the timing of transplantation, and cryopreservation as cell storage. Concurrently, we are investigating the influence of cell transplantation on myocardial remodeling in order to outline the mechanism of benefit afforded by donor cell engraftment. We believe that the timing of cell transplantation with respect to the progression of the underlying disease is critical in preventing ventricular thinning, dilation and preserving cardiac function.


CONCLUSIONS
This novel approach can be a clinically applicable biological therapy for patients with progressive DCM. More studies to uncover the specific molecular and cellular effects of cell transplantation on the host myocardium are necessary for future clinical application.
Ohno
Nobuhisa
N
Toronto General Hospital, Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Fedak
Paul W M
PW
Weisel
Richard D
RD
Komeda
Masashi
M
Mickle
Donald A G
DA
Li
Ren-Ke
RK
D000818:Animals; D002311:Cardiomyopathy, Dilated / Q000601:surgery*; D006224:Cricetinae; D006801:Humans; D032342:Muscle Cells / Q000637:transplantation*; D020257:Ventricular Remodeling / Q000502:physiology