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J Thorac Cardiovasc Surg 2006;131:799-804
© 2006 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Autologous skeletal myoblast transplantation in patients with nonacute myocardial infarction: 1-year follow-up

^a Department of Cardiology and Cardiovascular Surgery, Clínica Universitaria, Universidad de Navarra, Navarra, Spain
^b Department of Hematology and Cell Therapy Area, Clínica Universitaria, Universidad de Navarra, Navarra, Spain
^c Department of Nuclear Medicine, Clínica Universitaria, Universidad de Navarra, Navarra, Spain
^e Department of Hematology, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
^d Department of Cardiology and Cardiac Surgery, Hospital Clínico Universitario de Salamanca, Salamanca, Spain

Received for publication August 4, 2005; revisions received November 14, 2005; accepted for publication November 16, 2005.

^_* Address for reprints: Felipe Prósper, MD, Hematology and Cell Therapy, Clínica Universitaria, Avda Pío XII 36, Pamplona 31008, Spain. (Email: fprosper{at}unav.es).

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.

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