Surgical regeneration therapy using myoblast sheets for severe heart failure
Sawa, Y.
Kyobu Geka. Japanese Journal of Thoracic Surgery 60(5): 355-361
2007
ISSN/ISBN: 0021-5252 PMID: 17515078 Document Number: 609633
We have already reported that heart transplantation and left ventricular assist system (LVAS) are the useful surgical treatments for severe heart failure. However, these treatments have several problems such as donor limitation and complications and a novel strategy is desired. The autologous myoblast sheets attenuated the cardiac remodeling in the rat infarcted myocardium and dilated cardiomyopathy hamsters, leading to the improvement of cardiac performance. In this study, we will report the present results of heart transplantation and LVAS and also, report the development of porcine autologous myoblast sheets and hypothesized that autologous myoblast sheets regenerate the porcine infracted myocardium for clinical application. Skeletal myoblast (SM) isolated from leg muscle were cultured and detached from the dishes as single monolayer cell-sheet (tissue) at 20 degrees C using temperature-responsive culture dishes. Echocardiography demonstrated that cardiac systolic performance was significantly improved in SM group 4 weeks after operation rather than the control group. Both diastolic dysfunction and regional delayed relaxation in association with regional systolic function were recovered in the SM group, while the control group were not. Histologically, anterior wall was significantly recovered and dilatation of left ventricle was well attenuated in the SM group, while not in the other groups. SM-sheet implantation improved cardiac function by attenuating the cardiac remodeling and metabolic recovery in the impaired myocardium in the porcine ischemic myocardium, suggesting a promising strategy for clinical myocardial regeneration therapy.