Autologous skeletal myoblast transplantation in patients with nonacute myocardial infarction: 1-year follow-up.
OBJECTIVE
To determine the feasibility and safety of skeletal myoblast transplantation in patients with chronic myocardial infarction undergoing coronary artery bypass grafting.


METHODS
Twelve patients with a previous myocardial infarction and ischemic coronary artery disease underwent treatment with coronary artery bypass grafting surgery and intramyocardial injection of autologous skeletal myoblasts cultured with autologous serum. Global and regional cardiac function was assessed by echocardiogram. Fluorine 18 fluorodeoxyglucose and nitrogen 13-ammonia positron emission tomography studies were used to determine cardiac viability and perfusion. A group of historical control patients (n = 14) treated with coronary artery bypass grafting surgery without myoblast transplantation was analyzed.


RESULTS
The left ventricular ejection fraction improved from 35.5% +/- 2.3% (mean +/- SEM) before surgery to 55.1% +/- 8.2% at 12 months (P < .01) in the myoblast group and from 33.6% +/- 9.3% to 38.6% +/- 11% in the control group. Regional contractility also improved in the myoblast group, particularly in cardiac segments treated with skeletal myoblasts (wall motion score index: 3.02 +/- 0.17 at baseline vs 1.36 +/- 0.14 at 12 months; P < .0001). Quantitative fluorine 18-fluorodeoxyglucose and nitrogen 13-ammonia positron emission tomography showed an increase in viability and perfusion 12 months after surgery both globally and in segments treated with myoblasts (P = .012 and P = .004). Skeletal myoblast implantation was not associated with adverse events or an increased incidence of cardiac arrhythmias.


CONCLUSIONS
In patients with previous myocardial infarction, treatment with skeletal myoblasts in conjunction with coronary artery bypass is safe and feasible and is associated with an increased global and regional left ventricular function, improvement in viability, and perfusion of cardiac tissue and no significant incidence of arrhythmias.
Gavira
Juan J
JJ
Department of Cardiology and Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Navarra, Spain.
Herreros
Jesús
J
Perez
Ana
A
Garcia-Velloso
María José
MJ
Barba
Joaquín
J
Martin-Herrero
Francisco
F
Cañizo
Consuelo
C
Martin-Arnau
Ana
A
Martí-Climent
Josep M
JM
Hernández
Milagros
M
López-Holgado
Natalia
N
González-Santos
José María
JM
Martín-Luengo
Cándido
C
Alegria
Eduardo
E
Prósper
Felipe
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002478:Cells, Cultured; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D025401:Echocardiography, Stress; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D017202:Myocardial Ischemia / Q000601:surgery; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013318:Stroke Volume; D014182:Transplantation, Autologous; D016277:Ventricular Function, Left
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18