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Surgical and catheter delivery of autologous myoblasts in patients with congestive heart failure

Nature Clinical Practice Cardiovascular Medicine volume 3, pages S42–S45 (2006)Cite this article

Abstract

Autologous skeletal myoblast (ASM) transplantation is being explored as a possible therapy for patients who have suffered a myocardial infarction. Our initial experience with direct injection during coronary artery bypass grafting demonstrated that this method of delivery was both feasible and safe. In addition, proof of concept of the engraftment and survival of ASMs was shown. However, since many patients who have survived a myocardial infarction are not candidates for surgery, a less invasive delivery method is preferred. We implemented a series of translational research steps to bring catheter-based technology to a clinical application. This included assessing the biocompatibility of the ASM and a novel needle injection catheter using a 3-dimensional endoventricular navigation system, the bioretention and biodistribution of ASMs in a porcine model of myocardial infarction, and the safety and efficacy of ASM transplantation for cardiac function in the porcine model. After catheter functionality had been demonstrated, electromechanical mapping was used to assess the viability in the region of ASM transplantation, and echocardiography, electrocardiogram, and angiography tests were used to assess cardiac function 2 months after ASM transplantation. The results from these preclinical studies were used as a foundation for application of these concepts to a human clinical trial. Here we review the results from our preclinical experiments and surgical delivery clinical trial, and describe the recent clinical studies undertaken to assess the safety and feasibility of catheter-based ASM transplantation into human subjects.

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Figure 1: Positron emission tomography images were obtained at (A) baseline and at (B) 6 months after surgical transplantation of autologous skeletal myoblasts in a human
Figure 2: Final unipolar NOGA map of the left ventricle at the completion of the procedure

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Authors and Affiliations

  1. a Senior Medical Scientist, Department of Gene and Cell Research, Arizona Heart Institute, Phoenix, AZ, USA

    Shaun R Opie

  2. Clinical Investigator and Consultant Cardiologist, in the Department of Gene and Cell Research, Arizona Heart Institute, Phoenix, AZ, USA

    Nabil Dib

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  1. Shaun R Opie
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  2. Nabil Dib
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Correspondence to Nabil Dib.

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The authors declare no competing financial interests.

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Opie, S., Dib, N. Surgical and catheter delivery of autologous myoblasts in patients with congestive heart failure. Nat Rev Cardiol 3 (Suppl 1), S42–S45 (2006). https://doi.org/10.1038/ncpcardio0399

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