Stress and tissue Doppler echocardiographic evidence of effectiveness of myoblast transplantation in patients with ischaemic heart failure

Background: There is experimental evidence that transplanting skeletal myoblasts (SM) into the post-infarction myocardial scar improves regional and global left ventricular (LV) function. Aims: To evaluate short- and long-term regional and global LV functional effects of percutaneously transplanted SM in patients with ischaemic heart failure. Methods and results: Ten patients (mean age 60 10 years, 8 males) with dilated ischaemic cardiomyopathy underwent percutancous injection of autologous myoblasts. Regional and global LV function was evaluated by 2-dimensional echocardiography and tissue Doppler imaging (TDI) at rest and during low-dose dobutamine infusion to assess contractile reserve. After a baseline examination, sequential follow-ups were performed at 1, 3, and 6 months and 1 year. NYHA functional class decreased from 2.7 +/- 0.5 to 1.9 +/- 0.5 (p < 0.01) at one year. LV function and volumes at rest remained unchanged while contractile reserve significantly improved during follow-up. At low-dose dobutamine infusion, the peak systolic velocity in the regions of myoblasts injection significantly increased at TDI examination (from 7.7 +/- 2.1 to 8.6 +/- 1.8 cm/s, p=0.02); LV ejection fraction improved (from 40 +/- 9% to 46 +/- 8%, p < 0.0001) and end-systolic volumes decreased (from 56 28 to 50 25 ml/m(2), p=0.001) at 1 year. Conclusion: In patients with ischaemic heart failure, percutaneous injection of autologous myoblasts may improve regional and global LV systolic function during dobutamine infusion, at 1-year follow-up. (c) 2005 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.