Hibernating myocardium is a subset of ischemic cardiac disease characterized by viable
but dysfunctional tissue. Standard treatment for hibernating myocardium is coronary artery
bypass graft, which reduces arrhythmias and improves survival but does not fully restore
function, presenting a gap in currently available treatments. Large animal studies of
hibernating myocardium have identified impaired mitochondrial dynamics as a root cause of
persistent cardiac dysfunction despite surgical revascularization. This study presents a
novel
in vitro
model of hibernating myocardium cardiomyocytes to study
active mitochondrial respiration in hibernating myocardium cells, and to test the
paracrine effect of mesenchymal stem cells on impaired mitochondrial function. Exposure of
cardiomyocytes to hypoxic conditions of 1% oxygen for 24 hours resulted in a phenotype
consistent with hibernating myocardium cardiac tissue, including decreased respiratory
capacity under high work states, decreased expression of mitochondrial proteins, and
preserved cellular viability. Co-culture of hibernating myocardium cardiomyocytes with
mesenchymal stem cells restored mitochondrial respiratory function, potentially via an
increase in proliferator-activated receptor gamma coactivator 1-alpha-driven mitochondrial
biogenesis. Co-culture treatment of hibernating myocardium cardiomyocytes with mesenchymal
stem cells shows improvement in both mitochondrial function and ATP production, both of
which are critical for effectively functioning cardiac tissue. These results suggest that
mesenchymal stem cell therapy as an adjunct treatment to revascularization may address the
current gap in treatment for hibernating myocardium patients.