Adeliño Raquel, Martínez-Falguera Daina, Curiel Carolina, Teis Albert, Marsal Roger, Rodríguez-Leor Oriol, Prat-Vidal Cristina, Fadeuilhe Edgar, Aranyó Júlia, Revuelta-López Elena, Sarrias Axel, Bazan Víctor, Andrés-Cordón Joan F, Roura Santiago, Villuendas Roger, Lupón Josep, Bayes-Genis Antoni, Gálvez-Montón Carolina, Bisbal Felipe
ICREC Research Program, Germans Trias i Pujol Research Institute (IGTP), Barcelona, Spain.
Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Front Cardiovasc Med. 2022 Sep 20;9:983001. doi: 10.3389/fcvm.2022.983001. eCollection 2022.
To assess the arrhythmic safety profile of the adipose graft transposition procedure (AGTP) and its electrophysiological effects on post-myocardial infarction (MI) scar.
Myocardial repair is a promising treatment for patients with MI. The AGTP is a cardiac reparative therapy that reduces infarct size and improves cardiac function. The impact of AGTP on arrhythmogenesis has not been addressed.
MI was induced in 20 swine. Contrast-enhanced magnetic resonance (ce-MRI), electrophysiological study (EPS), and left-ventricular endocardial high-density mapping were performed 15 days post-MI. Animals were randomized 1:1 to AGTP or sham-surgery group and monitored with ECG-Holter. Repeat EPS, endocardial mapping, and ce-MRI were performed 30 days post-intervention. Myocardial SERCA2, Connexin-43 (Cx43), Ryanodine receptor-2 (RyR2), and cardiac troponin-I (cTnI) gene and protein expression were evaluated.
The AGTP group showed a significant reduction of the total infarct scar, border zone and dense scar mass by ce-MRI ( = 0.04), and a decreased total scar and border zone area in bipolar voltage mapping ( < 0.001). AGTP treatment significantly reduced the area of very-slow conduction velocity (<0.2 m/s) ( = 0.002), the number of deceleration zones ( = 0.029), and the area of fractionated electrograms ( = 0.005). No differences were detected in number of induced or spontaneous ventricular arrhythmias at EPS and Holter-monitoring. SERCA2, Cx43, and RyR2 gene expression were decreased in the infarct core of AGTP-treated animals ( = 0.021, = 0.018, = 0.051, respectively).
AGTP is a safe reparative therapy in terms of arrhythmic risk and provides additional protective effect against adverse electrophysiological remodeling in ischemic heart disease.
评估脂肪移植转位术（AGTP）的心律失常安全性及其对心肌梗死后（MI）瘢痕的电生理影响。
心肌修复是MI患者一种有前景的治疗方法。AGTP是一种心脏修复疗法，可减小梗死面积并改善心脏功能。AGTP对心律失常发生的影响尚未得到探讨。
对20头猪诱导MI。MI后15天进行对比增强磁共振成像（ce-MRI）、电生理研究（EPS）和左心室心内膜高密度标测。动物按1:1随机分为AGTP组或假手术组，并通过动态心电图监测。干预后30天重复进行EPS、心内膜标测和ce-MRI。评估心肌肌浆网钙ATP酶2（SERCA2）、连接蛋白43（Cx43）、兰尼碱受体2（RyR2）和心肌肌钙蛋白I（cTnI）的基因及蛋白表达。
ce-MRI显示AGTP组总梗死瘢痕、边缘区和致密瘢痕质量显著减少（P = 0.04），双极电压标测中总瘢痕和边缘区面积减小（P < 0.001）。AGTP治疗显著减小了极慢传导速度（<0.2 m/s）区域面积（P = 0.002）、减速区数量（P = 0.029）和碎裂电图区域面积（P = 0.005）。在EPS和动态心电图监测中，诱发性或自发性室性心律失常数量未检测到差异。AGTP治疗动物梗死核心区SERCA2、Cx43和RyR2基因表达降低（分别为P = 0.021、P = 0.018和P = 0.051）。
就心律失常风险而言，AGTP是一种安全的修复疗法，并为缺血性心脏病的不良电生理重塑提供额外保护作用。
