Cellular Therapy for Cardiovascular Disease Part 2—Delivery of Cells and Clinical Experience

Psaltis, Peter J.; Gronthos, Stan; Worthley, Stephen G.; Zannettino, Andrew

doi:10.4137/117954682000200001

Cited by 5 publications

(3 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It follows that fibrosis may be an important target for therapeutic intervention, including novel treatment options such as stem cells and genes. Mode of delivery remains a key consideration when evaluating such experimental agents [4]. In the setting of NICM, recent studies have adopted the vascular route for administration, via the coronary arterial system [5,6].…”

Section: Introductionmentioning

confidence: 99%

Assessment of myocardial fibrosis by endoventricular electromechanical mapping in experimental nonischemic cardiomyopathy

Psaltis

Carbone

Leong

et al. 2010

Int J Cardiovasc Imaging

Self Cite

View full text Add to dashboard Cite

Cardiac fibrosis plays an important prognostic role in nonischemic cardiomyopathy (NICM), making it a potential therapeutic target. Although electromechanical mapping has been used to identify myocardial scar and facilitate intramyocardial intervention in the setting of ischemic heart disease, its application has not been described in NICM. We assessed the detection of myocardial fibrosis by endoventricular electromechanical mapping in an experimental model of NICM. The NOGA® XP system was used to perform left ventricular mapping in twelve sheep that had undergone intracoronary doxorubicin dosing to induce NICM and in six healthy control animals. Results for endocardial voltage and mechanical shortening were evaluated against myocardial fibrosis burden, as determined by delayed-enhancement cardiac magnetic resonance and quantitative histomorphometry. Doxorubicin treatment resulted in dilated cardiomyopathy with moderate-severe impairment of left ventricular ejection fraction. Late gadolinium uptake was present in 9/12 doxorubicin animals, while histological fibrosis was approximately doubled compared to controls and was distributed multisegmentally throughout the left ventricle. Cardiomyopathy was associated with widespread reductions in unipolar and bipolar voltage amplitude and endocardial shortening. Each parameter showed an inverse relationship with the burden of fibrosis. Moreover, unipolar voltage and linear local shortening ratio displayed moderate accuracy for identifying myocardial segments with delayed contrast enhancement or increased fibrosis content, with optimal discriminatory thresholds of 7.5 mV and 11.5%, respectively. In this model of NICM, electromechanical mapping shows potential for delineating segmental differences in fibrosis. Pending clinical evaluation, it may therefore have applicability for directing targeted intramyocardial interventions in nonischemic heart disease.

show abstract

Section: Introductionmentioning

confidence: 99%

Assessment of myocardial fibrosis by endoventricular electromechanical mapping in experimental nonischemic cardiomyopathy

Psaltis

Carbone

Leong

et al. 2010

Int J Cardiovasc Imaging

Self Cite

View full text Add to dashboard Cite

show abstract

“…Cells can be directed to the heart (1) systemically (e.g., peripheral venous injection, growth factor mobilization), (2) by regional coronary vascular infusion, or (3) by local, direct myocardial injection [59]. The choice of delivery route is dependent on both the disease process requiring treatment and the type of cell to be transplanted.…”

Section: Methods For Cell Deliverymentioning

confidence: 99%

Intramyocardial Navigation and Mapping for Stem Cell Delivery

Psaltis

Zannettino

Gronthos

et al. 2009

J. of Cardiovasc. Trans. Res.

Self Cite

View full text Add to dashboard Cite

Method for delivery remains a central component of stem cell-based cardiovascular research. Comparative studies have demonstrated the advantages of administering cell therapy directly into the myocardium, as distinct from infusing cells into the systemic or coronary vasculature. Intramyocardial delivery can be achieved either transepicardially or transendocardially. The latter involves percutaneous, femoral arterial access and the retrograde passage of specially designed injection catheters into the left ventricle, making it less invasive and more relevant to wider clinical practice. Imaging-based navigation plays an important role in guiding catheter manipulation and directing endomyocardial injections. The most established strategy for three-dimensional, intracardiac navigation is currently endoventricular, electromechanical mapping, which offers superior spatial orientation compared to simple x-ray fluoroscopy. Its provision of point-by-point, electrophysiologic and motion data also allows characterization of regional myocardial viability, perfusion, and function, especially in the setting of ischemic heart disease. Integrating the mapping catheter with an injection port enables this diagnostic information to facilitate the targeting of intramyocardial stem cell delivery. This review discusses the diagnostic accuracy and expanding therapeutic application of electromechanical navigation in cell-based research and describes exciting developments which will improve the technology's sensing capabilities, image registration, and delivery precision in the near future.

show abstract

“…In the growth factor treatment [41], myocardial regeneration via stem cells mobilization and migration from tissues to injured myocardium is favoured by using specific growth factors like stromal cell-derived factor-1 (SDF-1) and stem cell factor (SCF). In particular, when the natural cell processes are not sufficient for MI healing, these phenomena are artificially induced and accelerated by supra doses of such chemical agents.…”

Section: Traditional Approaches For the Delivery Of Cells In The Injumentioning

confidence: 99%

Nanoscaffolds for Guided Cardiac Repair: The New Therapeutic Challenge of Regenerative Medicine

Ventrelli

Ricotti

Menciassi

et al. 2013

Journal of Nanomaterials

View full text Add to dashboard Cite

Cardiovascular diseases represent the leading cause of death and disability in the world. At the end-stage of heart failure, heart transplantation remains the ultimate option. Therefore, due to the numerous drawbacks associated with this procedure, new alternative strategies to repair the wounded heart are required. Cell therapy is a potential option to regenerate functional myocardial tissue. The characteristics of the ideal cardiac cell therapy include the use of the proper cell type and delivery methods as well as the choice of a suitable biomaterial acting as a cellular vehicle. Since traditional delivery methods are characterized by several counter backs, among which low cell survival, new engineered micro- and nanostructured materials are today extensively studied to provide a good cardiac therapy. In this review, we report the most recent achievements in the field of cell therapy for myocardial infarction treatment and heart regeneration, focusing on the most commonly used cell sources, the traditional approaches used to deliver cells at the damaged site, and a series of novel technologies based on recent advancements of bioengineering, highlighting the tremendous potential that nanoscaffolds have in this framework.

show abstract

Cellular Therapy for Cardiovascular Disease Part 2—Delivery of Cells and Clinical Experience

Cited by 5 publications

References 96 publications

Assessment of myocardial fibrosis by endoventricular electromechanical mapping in experimental nonischemic cardiomyopathy

Assessment of myocardial fibrosis by endoventricular electromechanical mapping in experimental nonischemic cardiomyopathy

Intramyocardial Navigation and Mapping for Stem Cell Delivery

Nanoscaffolds for Guided Cardiac Repair: The New Therapeutic Challenge of Regenerative Medicine

Contact Info

Product

Resources

About