Autologous intramyocardial injection of cultured skeletal muscle-derived stem cells in patients with non-acute myocardial infarction.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Herreros
Jesús
J
Department of Cardiology and Cardiovascular Surgery, Cli;nica Universitaria, Universidad de Navarra, Pamplona, Spain
Prósper
Felipe
F
Perez
Ana
A
Gavira
Juan J
JJ
Garcia-Velloso
María José
MJ
Barba
Joaquín
J
Sánchez
Pedro L
PL
Cañizo
Consuelo
C
Rábago
Gregorio
G
Martí-Climent
Josep M
JM
Hernández
Milagros
M
López-Holgado
Natalia
N
González-Santos
José María
JM
Martín-Luengo
Cándido
C
Alegria
Eduardo
E
D000328:Adult; D000368:Aged; D017690:Cell Transplantation / Q000009:adverse effects / Q000379:methods; D002478:Cells, Cultured; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016277:Ventricular Function, Left