European Heart Journal Advance Access originally published online on February 23, 2005
European Heart Journal 2005 26(15):1551-1556; doi:10.1093/eurheartj/ehi151
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Skeletal myoblast transplantation through a catheter-based coronary sinus approach: an effective means of improving function of infarcted myocardium
1Assistance Publique-Hôpitaux de Paris, Department of Cardiology, Hôpital Européen Georges Pompidou et Faculté de Médecine René Descartes, Université Paris V, Paris, France
2Department of Cardiology, CHU Robert Debré, Avenue du général Koenig, 51092 Reims Cedex, France
3INSERM U 633 and Ecole de Chirurgie de l'Assistance Publique-Hôpitaux de Paris, Paris, France
4INSERM EMI 0016, Faculté Necker, Paris, France
5INSERM U 582, Institut de Myologie, Groupe Hospitalier Pitié-Salpétrière, Paris, France
6Clinical Investigations Center 9201-INSERM, Hôpital Européen Georges Pompidou, Paris, France
7Department of Pathology and INSERM U 430, Hôpital Européen Georges Pompidou et Faculté de Médecine René Descartes, Université Paris V, Paris, France
8Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou et Faculté de Médecine René Descartes, Université Paris V, Paris, France
Received 27 August 2004; revised 13 December 2004; accepted 23 December 2004; online publish-ahead-of-print 23 February 2005.
* Corresponding author. Tel: +33 3 26 78 70 20; fax: +33 3 26 78 41 32. E-mail address: camille.brasselet{at}wanadoo.fr
Aims This study was designed to assess the functional effects of a transvenous coronary sinus technique of skeletal myoblast delivery in infarcted myocardium.
Methods and 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.
Conclusion These data suggest the functional efficacy of the transvenous coronary sinus technique as a less invasive means of cell delivery to infarcted myocardium.
Key Words: Cell therapy • Skeletal myoblasts • Transplantation • Myocardial infarction • Percutaneous intervention
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