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Cellular Cardiomyoplasty Using Autologous Satellite Cells: from Experimental to Clinical Study

Adult mammalian ventricular myocytes lack regenerative capability, consequently an injured heart is normally repaired by scar formation, hypertrophy of surviving myocytes, and hyperplasia of non-muscle cells. The possible existence of stem cells or progenitor cells for myocardium has been suggested recently, however it is clear that functionally significant myocardial regeneration has not been documented in diseased or injured heart. Contribution of other cells to the formation of ventricular myocytes appears to be negligible as evidenced by the consistent formation of scar after myocardial infarction. Satellite cells are adult stem cells responsible for growth, repair, and maintain homeostasis of skeletal muscle. We have been using autologous satellite cells for myocardial regeneration in dogs since 1989 and have applied this procedure to patients in 2001. Satellite cells have been successfully isolated, labeled, and implanted into injured heart with neomyocardial formation and functional improvement. Viable muscle cells with clear labeling are found in the infarct area after cell implantation. The labeled muscle cells have intercalated disks at cellular junctions. Significant improvements in contractile function are only observed in the animals that have successful engraftment after cell transplantation. Marked improvement in ejection fraction, myocardial perfusion, and local contractility are also found for patients after cellular cardiomyoplasty using autologous satellite cells. Most importantly, a heart failure patient after cellular cardiomyoplasty without conjunctional surgical procedure has recovered from congestive heart failure with significant improvement in myocardial perfusion, contractility, and metabolic activity at sits of cell implantation. Transplantation of satellite cells into injured heart can be a new treatment for myocardial infarction and heart failure.