Department of Medicine/Cardiology, University of Bonn, Bonn, Germany.
Cell Transplant. 2009;18(12):1289-97. doi: 10.3727/096368909X12483162197286. Epub 2009 Aug 5.
Intramyocardial transplantation of bone marrow-derived stem cells is a potential therapeutic option after myocardial infarction (MI). Intramyocardial administration is invasive but allows efficient and targeted stem cell delivery. Aims of this study were validation of minimal-invasive, echo-guided closed-chest cell transplantation (CTx) of mononuclear (MNC) or mesenchymal stem cells (MSC) and quantification of systolic left ventricular function and assessment of contractile reserve with high-resolution reconstructive 3D-echocardiography (r3D-echo) 3 weeks after CTx. Female Fischer344 rats received syngeneic male MNC, MSC, or medium after myocardial ischemia and reperfusion via echo-guided percutaneous injection (open-chest for control). Left ventricular systolic function was measured and dysfunctional myocardium was quantified with r3D-echo. For investigation of contractile reserve and myocardial viability r3D-echo was additionally conducted during low-dose dobutamine 3 weeks after CTx. Cell persistence after echo-guided CTx was quantified via real-time PCR; scar size was measured histologically. Echo-guided percutaneous CTx was feasible in all animals (n = 30) without periprocedural complications. After 3 weeks, 1.4 +/- 1.1% of transplanted MNC and 1.9 +/- 1.2% of MSC were detected. These numbers were comparable to those after open-chest intramyocardial injection of MNC (0.8 +/- 1.1%; n = 8, p = 0.3). In r3D-echo no functional benefit was associated with CTx after MI and reperfusion. All groups (MNC, MSC, and controls) revealed a significant decrease of dysfunctional myocardium and similar contractile reserve during inotropic stimulation.In conclusion, percutaneous echo-guided closed-chest CTx promises to be an effective and safe approach for CTx in small-animal research. However, intramyocardial CTx of MNC or MSC had no influence on systolic function and contractile reserve after reperfused MI.
心肌内骨髓源性干细胞移植是心肌梗死(MI)后的一种潜在治疗选择。心肌内给药具有侵袭性,但允许高效和靶向的干细胞递送。本研究的目的是验证微创、超声引导的闭式细胞移植(CTx)单核细胞(MNC)或间充质干细胞(MSC)的方法,并通过高分辨率重建 3D 超声心动图(r3D-echo)在 CTx 后 3 周评估收缩期左心室功能和收缩储备。雌性 Fischer344 大鼠接受同种异体雄性 MNC、MSC 或培养基,心肌缺血再灌注后通过超声引导经皮注射(开胸对照)。使用 r3D-echo 测量左心室收缩功能并量化功能障碍心肌。为了研究收缩储备和心肌活力,在 CTx 后 3 周期间,r3D-echo 还进行了低剂量多巴酚丁胺刺激。通过实时 PCR 量化超声引导 CTx 后细胞的持续存在;通过组织学测量疤痕大小。所有动物(n = 30)均可行超声引导经皮 CTx,无围手术期并发症。3 周后,检测到 1.4 +/- 1.1%的移植 MNC 和 1.9 +/- 1.2%的 MSC。这些数字与开胸心肌内注射 MNC (0.8 +/- 1.1%;n = 8,p = 0.3)相当。在 r3D-echo 中,MI 后再灌注时 CTx 与功能获益无关。所有组(MNC、MSC 和对照组)在正性肌力刺激期间均显示出功能障碍心肌的显著减少和相似的收缩储备。总之,经皮超声引导闭式 CTx 有望成为小动物研究中 CTx 的有效和安全方法。然而,MI 后再灌注时,心肌内 MNC 或 MSC 的 CTx 对收缩功能和收缩储备没有影响。
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