Stem cell therapy improves myocardial perfusion and cardiac synchronicity: new application for echocardiography.
OBJECTIVE
Intravenous delivery of mesenchymal stem cell (MSC) is a noninvasive approach for myocardial tissue repair. We aimed to test this strategy in a pig model of myocardial infarction and to examine the usefulness of new echocardiographic applications to monitor cardioprotective effects of stem cell therapy.


METHODS
Pigs (n = 8) received autologous or allogeneic MSCs (1 x 10(6)/kg body weight) labeled with fluorescent dye 48 hours after proximal left anterior descending coronary artery occlusion. Infarct size, myocardial function, and perfusion (A x beta) were assessed by myocardial contrast echocardiography and standard histologic methods after 1 month.


RESULTS
Morphologic analysis revealed that labeled MSCs migrated in the peri-infarct region resulting in smaller infarct size by myocardial contrast echocardiography (control vs autologous and allogeneic MSC: 38 +/- 10% vs 25 +/- 5% and 28 +/- 6%, P < .01), higher fractional area shortening (23 +/- 3% vs 34.0 +/- 7% and 28 +/- 2%, P < .01), higher cardiac synchrony (167 +/- 36 vs 68 +/- 17 and 85 +/- 26 milliseconds, P < .003), and improved microvascular flow A x beta in the ischemic border zone (0.18 +/- 0.2 vs 0.56 +/- 0.3 and 0.49 +/- 0.2, P < .03).


CONCLUSIONS
Systemic delivery of autologous and allogeneic MSCs preserves myocardial viability even in large animals and is, therefore, an attractive approach for tissue repair. Myocardial contrast echocardiography is useful to evaluate microvascular perfusion, which was enhanced by MSCs.
Wolf
David
D
Department of Cardiology and Angiology, University of Heidelberg, Heidelberg, Germany.
Reinhard
Adrian
A
Krause
Ulf
U
Seckinger
Anja
A
Katus
Hugo A
HA
Kuecherer
Helmut
H
Hansen
Alexander
A
D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage; D003326:Coronary Circulation / Q000502:physiology*; D004195:Disease Models, Animal; D004452:Echocardiography / Q000379:methods*; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D007275:Injections, Intravenous; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013552:Swine; D016896:Treatment Outcome
D003287:Contrast Media