HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Christian Latremouille Alain Carpentier Juan C. Chachques Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shafy, A. Articles by Chachques, J. C. Search for Related Content PubMed Articles by Shafy, A. Articles by Chachques, J. C. Related Collections Cardiac - other Congestive Heart Failure Coronary disease Myocardial infarction

J Thorac Cardiovasc Surg 2009;138:994-1001
© 2009 The American Association for Thoracic Surgery

Evolving Technology/Basic Science

Association of electrostimulation with cell transplantation in ischemic heart disease

^a Laboratory of Biosurgical Research, Pompidou Hospital, University of Paris, Paris, France
^b Department of Cardiology, Pompidou Hospital, University of Paris, Paris, France

Received for publication July 30, 2008; revisions received January 2, 2009; accepted for publication February 3, 2009.

^_* Address for reprints: Juan C. Chachques, MD, PhD, Department of Cardiovascular Surgery, Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France. (Email: j.chachques{at}brs.aphp.fr).

Background: Until now, cell therapy has constituted a passive therapeutic approach; the only effects seem to be related to the reduction of the myocardial fibrosis and the limitation of the adverse ventricular remodeling. Cardiac resynchronization therapy is indicated in patients with heart failure to correct conduction disorders associated with chronic systolic and diastolic dysfunction. The association of electrostimulation with cellular cardiomyoplasty could be a way to transform passive cell therapy into "dynamic cellular support." Electrostimulation of ventricles following skeletal myoblast implantation should induce the contraction of the transplanted cells and a higher expression of slow myosin, which is better adapted for chronic ventricular assistance. The purpose of this study is to evaluate myogenic cell transplantation in an ischemic heart model associated with cardiac resynchronization therapy.

Methods: Twenty two sheep were included. All animals underwent myocardial infarction by ligation of 2 coronary artery branches (distal left anterior descending artery and D2). After 4 weeks, autologous cultured myoblasts were injected in the infarcted areas with or without pacemaker implantation. Atrial synchronized biventricular pacing was performed using epicardial electrodes. Echocardiography was performed at 4 weeks (baseline) and 12 weeks after infarction.

Results: Echocardiography showed a significant improvement in ejection fraction and limitation of left ventricular dilatation in cell therapy with cardiac resynchronization therapy as compared with the other groups. Viable cells were identified in the infarcted areas. Differentiation of myoblasts into myotubes and enhanced expression of slow myosin heavy chain was observed in the electrostimulated group. Transplantation of cells with cardiac resynchronization therapy caused an increase in diastolic wall thickening in the infarcted zone relative to cells-only group and cardiac resynchronization therapy–only group.

Conclusions: Biventricular pacing seems to induce synchronous contraction of transplanted myoblasts and the host myocardium, thus improving ventricular function. Electrostimulation was related with enhanced expression of slow myosin and the organization of myoblasts in myotubes, which are better adapted at performing cardiac work. Patients with heart failure presenting myocardial infarct scars and indication for cardiac resynchronization therapy might benefit from simultaneous cardiac pacing and cell therapy.

This article has been cited by other articles:

				J. R. Venugopal, M. P. Prabhakaran, S. Mukherjee, R. Ravichandran, K. Dan, and S. Ramakrishna Biomaterial strategies for alleviation of myocardial infarction J R Soc Interface, January 7, 2012; 9(66): 1 - 19. [Abstract] [Full Text] [PDF]

				B.-E. Strauer and G. Steinhoff 10 Years of Intracoronary and Intramyocardial Bone Marrow Stem Cell Therapy of the Heart: From the Methodological Origin to Clinical Practice J. Am. Coll. Cardiol., September 6, 2011; 58(11): 1095 - 1104. [Abstract] [Full Text] [PDF]