© 2005 European Society of Cardiology
Stress and tissue Doppler echocardiographic evidence of effectiveness of myoblast transplantation in patients with ischaemic heart failure
Department of Cardiology, Thoraxcenter, Erasmus MC Bd406, Dr. Molewaterplein 40, 3015-GD Rotterdam, The Netherlands
* Corresponding author. E-mail address: p.w.j.c.serruys{at}erasmusmc.nl (P.W. Serruys).
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Abstract |
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Background: There is experimental evidence that transplanting skeletal myoblasts (SM) into the post-infarction myocardial scar improves regional and global left ventricular (LV) function.
Aims: To evaluate short- and long-term regional and global LV functional effects of percutaneously transplanted SM in patients with ischaemic heart failure.
Methods and results: Ten patients (mean age 60 ± 10 years, 8 males) with dilated ischaemic cardiomyopathy underwent percutaneous injection of autologous myoblasts. Regional and global LV function was evaluated by 2-dimensional echocardiography and tissue Doppler imaging (TDI) at rest and during low-dose dobutamine infusion to assess contractile reserve. After a baseline examination, sequential follow-ups were performed at 1, 3, and 6 months and 1 year. NYHA functional class decreased from 2.7 ± 0.5 to 1.9 ± 0.5 (p < 0.01) at one year. LV function and volumes at rest remained unchanged while contractile reserve significantly improved during follow-up. At low-dose dobutamine infusion, the peak systolic velocity in the regions of myoblasts injection significantly increased at TDI examination (from 7.7 ± 2.1 to 8.6 ± 1.8 cm/s, p = 0.02); LV ejection fraction improved (from 40 ± 9% to 46 ± 8%, p < 0.0001) and end-systolic volumes decreased (from 56 ± 28 to 50 ± 25 ml/m2, p = 0.001) at 1 year.
Conclusion: In patients with ischaemic heart failure, percutaneous injection of autologous myoblasts may improve regional and global LV systolic function during dobutamine infusion, at 1-year follow-up.
Key Words: Myocardial infarction • Cell transplantation • LV function • Stress echocardiography • Tissue Doppler imaging
Received May 5, 2005; Revised August 18, 2005; Accepted December 8, 2005
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