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Catheter-Based intramyocardial injection of autologous skeletal myoblasts as a primary treatment of ischemic heart failure

Clinical experience with Six-Month Follow-Up

Pieter C. Smits, MD, PhD^*,*, Robert-Jan M. van Geuns, MD, PhD, Don Poldermans, MD, PhD^*, Manolis Bountioukos, MD^*, Emile E. M. Onderwater^*, Chi Hang Lee, MD^*, Alex P. W. M. Maat, MD^* and Patrick W. Serruys, MD, PhD^*

^* Department of Cardiology, Thorax Center, Rotterdam, The Netherlands
Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands

View larger version (70K): [in a new window]   Figure 1 NOGA maps (left = unipolar voltage maps; right = linear local shortening maps) in the right anterior oblique (top) and anteroposterior (bottom) views of Patient no. 2 after 19 injections with autologous skeletal myoblasts in the anteroseptal and anterior myocardial scar and border zone. The myocardial scar is indicated in red on the unipolar voltage map (<6 mV) and on the local linear shortening map (<2%). The black dots indicate the transendocardial injection sites.

View larger version (17K): [in a new window]   Figure 2 Changes in regional wall thickening for all 304 magnetic resonance imaging segments. The open and solid bars indicate the number of segments with wall thickening at baseline and three-month follow-up (FU), respectively. Compared with baseline, less segments showed thinning and more segments showed moderate thickening at three-month follow-up, and less segments with greater wall thickening were observed at that point.

View larger version (22K): [in a new window]   Figure 3 Cumulative distribution of regional wall thickening segments by magnetic resonance imaging at baseline (open circles) and three-month follow-up (x). At follow-up, there was a descriptive shift toward less thinning and moderate thickening in the target regions and less thickening in the normokinetic and hyperkinetic remote areas, indicating a kind of left ventricular remodeling.