Intravenous Followed by X-ray Fused with MRI-Guided Transendocardial Mesenchymal Stem Cell Injection Improves Contractility Reserve in a Swine Model of Myocardial Infarction

J Cardiovasc Transl Res. 2015 Oct;8(7):438-48. doi: 10.1007/s12265-015-9654-0. Epub 2015 Sep 15.

Abstract

The aim of this study is to determine the effects of early intravenous (IV) infusion later followed by transendocardial (TE) injection of allogeneic mesenchymal stem cells (MSCs) following myocardial infarction (MI). Twenty-four swine underwent balloon occlusion reperfusion MI and were randomized into 4 groups: IV MSC (or placebo) infusion (post-MI day 2) and TE MSC (or placebo) injection targeting the infarct border with 2D X-ray fluoroscopy fused to 3D magnetic resonance (XFM) co-registration (post-MI day 14). Continuous ECG recording, MRI, and invasive pressure-volume analyses were performed. IV MSC plus TE MSC treated group was superior to other groups for contractility reserve (p = 0.02) and freedom from VT (p = 0.03) but had more lymphocytic foci localized to the peri-infarct region (p = 0.002). No differences were observed in post-MI remodeling parameters. IV followed by XFM targeted TE MSC therapy improves contractility reserve and suppresses VT but does not affect post-MI remodeling and may cause an immune response.

Keywords: Allogeneic; Immune response; Intravenous; Mesenchymal stem cell; Multiple dose; Myocardial infarction; Stem cell; Swine; Transendocardial.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / diagnosis
  • Cell Separation / methods
  • Endocardium
  • Hemodynamics
  • Injections / methods
  • Injections, Intravenous
  • Magnetic Resonance Imaging*
  • Mesenchymal Stem Cell Transplantation / methods*
  • Mesenchymal Stem Cells / radiation effects*
  • Myocardial Contraction / physiology*
  • Myocardial Infarction / pathology
  • Myocardial Infarction / surgery*
  • Random Allocation
  • Swine