A comparison between percutaneous and surgical transplantation of autologous skeletal myoblasts in a swine model of chronic myocardial infarction.
OBJECTIVE
Our aim was to compare the efficacy of surgical versus percutaneous administration of skeletal myoblasts (SkM) in a swine model of chronic myocardial infarction and to determine the mechanism(s) involved in their beneficial effect.


METHODS
Two months after induction of myocardial infarction (MI), Goettingen miniature pigs underwent autologous SkM transplant either by direct surgical injection (n=6) or percutaneous access and intramyocardial delivery under fluoroscopic and echocardiographic guidance (n=6). Control animals received media alone (n=4). Functional analysis was performed by 2D echocardiography. Myoblast engraftment, in vivo cell differentiation, vessel formation, fibrosis, and the ratio between collagen type I/III deposition were analyzed in the infarct (IA) and non-infarct area (NIA) by immunohistochemistry.


RESULTS
Animals received a median of 407.55+/-115x10(6) BrdU-labeled autologous SkM. Myoblast transplant was associated with a statistically significant increase in left ventricular ejection fraction (p<0.01), increased vasculogenesis and decreased fibrosis (p<0.05), and reduced collagen type I/III ratio in the IA and NIA areas as compared with control animals. No differences were found between groups receiving SkM by percutaneous or surgical access.


CONCLUSIONS
Our results indicate that increased vasculogenesis and changes in matrix remodeling with decreased fibrosis are associated with the beneficial effect of SkM transplant in chronic MI. The equivalent benefit observed from surgical and percutaneous delivery has important clinical implications.
Gavira
Juan José
JJ
Department of Cardiology and Cardiovascular Surgery, University of Navarra, Spain.
Perez-Ilzarbe
Maitane
M
Abizanda
Gloria
G
García-Rodríguez
Alba
A
Orbe
Josune
J
Páramo
José Antonio
JA
Belzunce
Miriam
M
Rábago
Gregorio
G
Barba
Joaquín
J
Herreros
Jesús
J
Panizo
Angel
A
de Jalón
José A García
JA
Martínez-Caro
Diego
D
Prósper
Felipe
F
D000199:Actins / Q000032:analysis; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D002454:Cell Differentiation; D003094:Collagen / Q000032:analysis; D004452:Echocardiography; D005355:Fibrosis; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D007279:Injections, Subcutaneous; D023421:Models, Animal; D032448:Myoblasts, Skeletal / Q000637:transplantation*; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D018919:Neovascularization, Physiologic; D013552:Swine; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left; D020257:Ventricular Remodeling
D000199:Actins; D015415:Biomarkers; D003094:Collagen