Perkutane intramyokardiale Implantation von autologen Myoblasten bei ischämischer Kardiomyopathie

İnce, Hüseyin; Petzsch, Michael; Rehders, Tim C.; Kische, Stephan; Chatterjee, Tushar; Nienaber, Christoph

doi:10.1007/s00059-005-2623-7

Cited by 15 publications

(8 citation statements)

References 44 publications

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“…In line with the findings of trans-epicardial myoblast administration, an increased occurrence of cardiac arrhythmias was observed following transendocardial delivery, emphasizing the need for prophylactic ICD implantation [82,83,186,[189][190][191]. Nonetheless, these small-sized clinical studies suggested that trans-coronary-venous [186] and transendocardial [82,83,[189][190][191][192] cell delivery of skeletal myoblasts was associated with improvements in cardiac performance and clinical symptoms. The SEISMIC study [193] is a relatively small open-label randomized study in which patients were randomized to receive either skeletal myoblasts by trans-endocardial injection or optimal medical treatment.…”

Section: Skeletal Myoblasts Therapysupporting

confidence: 69%

Cell Therapy for the Treatment of Chronic Ischemic Heart Disease

Rodrigo

Ramshorst²,

Beeres³

et al. 2011

CPD

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Over the last decade, much was learned about the biology of several types of stem and progenitor cells. It has become apparent that various cell sources may have the capacity to promote cardiomyogenesis and new blood vessel formation through different mechanisms, forming the rationale for cell-based therapy in patients with chronic ischemic heart disease. After initial clinical studies have provided evidence for safety of cell administration, larger randomized trials demonstrated variable effects on myocardial perfusion and contractile performance. Although cell-based therapy is a promising strategy for the treatment of myocardial disease, many questions remain to be answered with respect to the optimal cell type, delivery route and mechanism of action in order to improve the outcome of cardiac cell therapy. This paper aims to provide an overview of the methods available to apply cell-based therapy in chronic ischemic myocardial disease. The different cell types that have been tested in (pre)clinical trials and their proposed mechanism of action will be discussed, along with the possible routes of cell delivery. Furthermore, the experience from experimental and clinical studies will be summarized, and innovative strategies to enhance the efficacy of cell therapy, for example by improving cell retention and survival, will be reviewed.

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Section: Skeletal Myoblasts Therapysupporting

confidence: 69%

Cell Therapy for the Treatment of Chronic Ischemic Heart Disease

Rodrigo

Ramshorst²,

Beeres³

et al. 2011

CPD

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“…The myoblast cellular graft was intramyocardially injected into the targeted treatment region utilising the MyoCath ™ catheter delivery system under fluoroscopic guidance as previously described. 5 The treatment group received a dose in the range of 150-800 million cells, dependent on the size of ventricular scar tissue to be treated. Since the cell concentration was maintained at 50 million cells/mL, the final number of injections varied per patient.…”

Section: Quadriceps Muscle Biopsy and Cell Culture Expansion And Tranmentioning

confidence: 99%

Final results of a phase IIa, randomised, open-label trial to evaluate the percutaneous intramyocardial transplantation of autologous skeletal myoblasts in congestive heart failure patients: the SEISMIC trial

Duckers

Houtgraaf²,

Hehrlein³

et al. 2011

EuroIntervention

106

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Aims: The SEISMIC study was an open-label, prospective, randomised study to assess the safety and feasibility of percutaneous myoblast implantation in heart failure patients with implanted cardioverter-defibrillators (ICD). Methods and results: Patients were randomised 2:1 to autologous skeletal myoblast therapy vs. optimal medical treatment. The primary safety end-point was defined as the incidence of procedural and device related serious adverse events, whereas the efficacy endpoints were defined as the change in global LVEF by MUGA scan, change in NYHA classification of heart failure and in the distance achieved during a sixminute walk test (6MW) at 6-month follow-up. Forty subjects were randomised to the treatment arm (n=26), or to the control arm (n=14). There were 12 sustained arrhythmic events and one death after episodes of ventricular tachycardia (VT) in the treatment group and 14 events in the control group (P=ns). At 6-month follow-up, 6MW distance improved by 60.3±54.1 meters in the treated group as compared to no improvement in the control group (0.4±185.7 meters; P=ns). In the control group, 28.6% experienced worsening of heart failure status (4/14), while 14.3% experienced an improvement in NYHA classification (2/14). In the myoblast-treatment arm, one patient experienced a deterioration in NYHA classification (8.0%), whereas five patients improved one or two classes (20.0%; P=0.06). However, therapy did not improve global LVEF measured by MUGA at 6-month follow-up. Conclusions: These data indicate that implantation of myoblasts in patients with HF is feasible, appears to be safe and may provide symptomatic relief, though no significant effect was detected on global LVEF.

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“…Exciting results of the experimental studies have led to clinical studies which demonstrated benefit of the stem cells on left ventricular functions after acute myocardial infarction or ischemic cardiomyopathy (Chachques et al 2004;Schuster et al 2004;Ince et al 2005). Being accepted as an effective and safe way of performing stem cells into infarcted myocardial region, intracoronary infusion has become a preferable route in particularly acute MI patients (Chen et al 2004;Fernandez-Aviles et al 2004).…”

Section: Discussionmentioning

confidence: 99%

Intracoronary Stem Cell Infusion in Heart Transplant Candidates

Tayyareci

Umman

Sezer

et al. 2007

Tohoku J. Exp. Med.

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The stem cell transplantation is emerging as a potential therapeutic modality for patients with heart failure. It has been demonstrated that intracoronary stem cell transplantation had beneficial effects on left ventricular perfusion and contractile functions. We hypothesized that patients with end-stage ischemic cardiomyopathy, who are candidates for heart transplantation, could also benefit from autologous intracoronary stem cell transplantation. We performed a prospective, openlabeled study in 10 patients with end-stage ischemic cardiomyopathy, who were on the waiting list for heart transplantation. Each patient received bone marrow-derived mononuclear cell infusion via balloon catheter in the target vessel, which had been revascularized by percutaneous intervention and was patent before the procedure. Clinical and laboratory evaluations, a treadmill exercise test, echocardiography, and single photon emission tomography (SPECT) were performed to the patients at baseline and 6 months after stem cell infusion. At 6-month follow-up of the eight patients who were able to complete the study, we revealed a significant increase in ejection fraction (from 30.0 ± 6.6% to 36.2 ± 7.3%; p = 0.001) in echocardiographic evaluation. SPECT evaluation also displayed a reduction in infarct area (50.4 ± 16.1% to 44.1 ± 12.5%; p = 0.003). Both myocardial oxygen consumption ( p = 0.001) and metabolic equivalents ( p = 0.001) were significantly increased at 6-month follow-up. These results demonstrate that intracoronary stem cell transplantation ameliorates heart failure symptoms and improves left ventricular function and perfusion. Therefore intracoronary stem cell transplantation may be used as an alternative treatment option for heart transplant candidates. cellular cardiomyoplasty; heart transplant candidates; intracoronary infusion; stem cells; ischemic cardiomyopathy © 2007 Tohoku University Medical PressCongestive heart failure (CHF) of ischemic origin remains to be a major clinical problem despite major advances in medical and surgical treatment of patients with myocardial infarction (MI) both during acute and chronic phases. In the acute setting of MI, revascularization procedures,

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Perkutane intramyokardiale Implantation von autologen Myoblasten bei ischämischer Kardiomyopathie

Abstract: Transcatheter transplantation of autologous skeletal myoblasts for severe left ventricular dysfunction in postinfarction patients is feasible, safe and promising and, thus, warrants the scrutiny of larger randomized double-blind multi-center trials with longer follow-up surveillance.

Cited by 15 publications

References 44 publications

Cell Therapy for the Treatment of Chronic Ischemic Heart Disease

Cell Therapy for the Treatment of Chronic Ischemic Heart Disease

Final results of a phase IIa, randomised, open-label trial to evaluate the percutaneous intramyocardial transplantation of autologous skeletal myoblasts in congestive heart failure patients: the SEISMIC trial

Intracoronary Stem Cell Infusion in Heart Transplant Candidates

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