Abstract 19222: Mid-Term Outcome of Cardiac Regenerative Therapy With Autologous Myoblast Cell Sheet Transplantation for Severe Heart Failure
Background: Transplantation of autologous somatic tissue-derived cells into the heart has been shown to yield functional recovery of the failing heart via “paracrine effects” that enhance the native regenerative process. We have introduced cell-sheet methods with temperature-responsive dish for introducing skeletal myoblast cell (SMBc) for treating severe heart failure (HF), in which maximize the paracrine effects. We herein report mid-term outcome and therapeutic efficacy of SMBc sheet transplantation for treating severe HF.
Methods: This study enrolled 36 patients (mean age, 54±15 years, ischemic etiology in 15 and non-ischemic etiology in 21 patients) with chronic advanced HF despite optimum treatments. Scaffold-free cell-sheets containing SMBc (average: 4.5±2.7х108 cells) was transplanted over the left ventricular (LV) free wall via the left thoracotomy without concomitant procedures. Average follow-up was 2.6 (0.6-6.1) years.
Results: All patients discharged from the hospital without procedure-related complications. In the ischemic etiology, NYHA functional class was significantly decreased (2.9±0.5 to 1.9±0.3 p<0.05) and 6-minute walk test was increased (405±116 to 476±126m p<0.05) at 1 year, while these values maintained until the latest follow-up. Echocardiographically, LV systolic and diastolic diameters significantly decreased and ejection fraction significantly increased. In addition, pulmonary vascular resistance (PVR) significantly decreased (2.6±1.6 to 2.0±0.7 WU p<0.05) in the ischemic etiology. In the non-ischemic etiology, NYHA functional class was also significantly decreased (2.7±0.6 to 2.4±0.7 p<0.05), while echocardiographic parameters were only maintained at 1 year. Incidence of re-in-hospital treatment for HF was significantly decreased in both groups after this treatment (ischemic: 0.84 to 0.15 event/year p<0.01, non-ischemic: 0.74 to 0.46 event/year p<0.05). Three-year freedom from all-cause death was 90.9% in the ischemic etiology and 74.0% in the non-ischemic etiology.
Conclusions: Mid-term outcome of SMBc sheet transplantation was acceptable for improvement of quality of life in both etiologies. However functional recovery was gained especially in the patients with ischemic etiology.
Author Disclosures: K. Domae: None. S. Miyagawa: None. K. Toda: None. Y. Yoshikawa: None. S. Fukushima: None. S. Saito: None. A. Saito: None. T. Kuratani: None. T. Ueno: None. Y. Sawa: None.
- © 2016 by American Heart Association, Inc.