Fast track cardiac anaesthesia in a new setup

Abstract

Objectives: Cell transplantation is a novel promising strategy for the treatment of end-stage heart failure. In a rat model of hypertrophic cardiomyopathy, we studied the hemodynamic and molecular effects of intra-coronary delivery of MSC.Methods: Sprague-Dawley rats underwent aortic banding and were followed by echocardiography for development of heart failure. After a decrease in fractional shortening of 25% from baseline, intracoronary randomized injection of MSC (n=28) or PBS (n=20) was performed. Hemodynamic assessment, swim testing to exhaustion and measurement of inflammatory markers was performed prior to sacrifice on post-operative day 7, 14, 21 or 28.Results: MSC injection improved systolic function in the MSC group compared to the control group (mean ± SD, max dP/dt 3048 mmHg/s ± 230 vs. 2169 ± 97 at 21 days, and 3573 ± 741 vs. 1363 ± 322 at 28 days, p<0.001). LVESD was significantly reduced at 28 days in the MSC group compared to the control group (7.0 ± 0.2 vs. 7.4 ± 1.5 mm, p=0.01). Time to exhaustion was similarly increased in the MSC group compared to controls (407 ± 34 seconds vs. 264 ± 24 seconds at 21 days, and 487 ± 35 seconds vs. 306 ± 27 seconds at 28 days, p<0.001).Conclusions: In this model of hypertrophic cardiomyopathy, MSC transplantation during heart failure improved hemodynamic performance, ventricular remodeling and maximal exercise tolerance. These effects were most remarkable at 21 and 28 days. This study suggests a potential use of this treatment strategy for the management of hypertrophic heart failure.