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Endocardial electrogram analysis after intramyocardial injection of mesenchymal stem cells in the chronic ischemic myocardium.
- Source :
-
Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2009 Oct; Vol. 32 (10), pp. 1319-28. Date of Electronic Publication: 2009 Aug 19. - Publication Year :
- 2009
-
Abstract
- Background: Cell injection therapies have been introduced for the treatment of patients with coronary heart disease. However, intramyocardial injection of bone marrow (BM)-derived cells may generate proarrhythmogenicity.<br />Methods: Two weeks after the placement of a circumflex artery-ameroid constrictor, 21 pigs received mesenchymal stem cells (MSC, n = 9), mononuclear (BM)-derived stem cells (MNC, n = 6), and placebo (n = 6) using a electromechanical mapping (EMM)-guided percutaneous transendocardial injection catheter. At week 6, EMM was repeated and the injected areas were analyzed in detail to evaluate local bipolar electrogram fragmentation, duration, and amplitude. Myocardial fibrosis was evaluated by a quantitative histological analysis.<br />Results: At week 6, the injection of MSC or MNC did not increase local electrogram fragmentation (MSC group: 1.4 +/- 0.3 vs. 1.3 +/- 0.2; MNC group: 1.4 +/- 0.2 vs. 1.3 +/- 0.2; P = NS), prolong electrogram duration (MSC group: 27.1 +/- 7.8 ms vs. 23.7 +/- 2.0 ms; MNC group: 27.8 +/- 3.5 ms vs. 26.8 +/- 5.6 ms; P = NS), or decrease bipolar voltages (MSC group 2.7 +/- 0.9 mV vs. 2.8 +/- 1.0 mV; MNC group 2.0 +/- 1.0 mV vs. 1.7 +/- 0.4 mV). From week 2 to week 6, mean left ventricular ejection fraction increased in the MSC group (37.9 +/- 4.2% vs. 45.9 +/- 2.2%; P = 0.039) only. Histological analysis of the ischemic regions revealed 17.6 +/- 5% myocardial fibrosis in the MNC group vs. 13.6 +/- 3.4% MSC vs. 28.7 +/- 8.7% in the control group (P = 0.038 and P = 0.013). No death occurred in any animal after the injection procedure.<br />Conclusion: Intramyocardial injection of MSC or MNC do not increase fragmentation and duration of endocardial electrograms in the injected ischemic myocardium but attenuate ischemic damage and therefore may not create an electrophysiological substrate for reentry tachycardias.
- Subjects :
- Animals
Chronic Disease
Swine
Treatment Outcome
Arrhythmias, Cardiac diagnosis
Arrhythmias, Cardiac etiology
Electrocardiography methods
Mesenchymal Stem Cell Transplantation adverse effects
Mesenchymal Stem Cell Transplantation methods
Myocardial Ischemia diagnosis
Myocardial Ischemia surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8159
- Volume :
- 32
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Pacing and clinical electrophysiology : PACE
- Publication Type :
- Academic Journal
- Accession number :
- 19694971
- Full Text :
- https://doi.org/10.1111/j.1540-8159.2009.02483.x