Skeletal myoblast transplantation through a catheter-based coronary sinus approach: an effective means of improving function of infarcted myocardium.
OBJECTIVE
This study was designed to assess the functional effects of a transvenous coronary sinus technique of skeletal myoblast delivery in infarcted myocardium.


RESULTS
An anterior myocardial infarction was created percutaneously in 14 sheep. Simultaneously, a muscle biopsy was harvested and expanded. Two weeks later, sheep were instrumented percutaneously with a dedicated catheter incorporating an extendable needle for puncture of the venous wall and, under endovascular ultrasound guidance, a microcatheter was advanced through the needle into the target scar for cell delivery. Following the baseline echocardiographic assessment of left ventricular (LV) function, sheep were randomly allocated to receive four-staged in-scar injections of either autologous cells (n=7) or culture medium (n=7). Two months later, LV function was reassessed blindly and hearts were explanted for subsequent histological and immunohistochemical analysis. There were no acute procedural complications. Baseline LV ejection fraction (EF) was significantly lower in transplanted sheep than in controls [38% (35-48) vs. 51% (38-55), respectively, P=0.03; median (range)]. Two months later, LVEF was significantly higher in the transplanted group than in controls [50% (47-56) vs. 39% (36-47), respectively, P=0.002]. Clusters of myoblasts were identified by histology and immunohistochemistry in three of the seven transplanted sheep.


CONCLUSIONS
These data suggest the functional efficacy of the transvenous coronary sinus technique as a less invasive means of cell delivery to infarcted myocardium.
Brasselet
Camille
C
Assistance Publique-Hôpitaux de Paris, Department of Cardiology, Hôpital Européen Georges Pompidou et Faculté de Médecine René Descartes, Université Paris V, Paris, France. camille.brasselet@wanadoo.fr
Morichetti
Miguel Cortes
MC
Messas
Emmanuel
E
Carrion
Claire
C
Bissery
Alvine
A
Bruneval
Patrick
P
Vilquin
Jean-Thomas
JT
Lafont
Antoine
A
Hagège
Albert A
AA
Menasché
Philippe
P
Desnos
Michel
M
D000818:Animals; D006328:Cardiac Catheterization / Q000379:methods; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012756:Sheep; D016277:Ventricular Function, Left / Q000502:physiology