Right ventricular dysfunction is a predictor for worse outcomes in patients with
congenital heart disease.
Myocardial ischemia is primarily associated with
right ventricular dysfunction in patients with
congenital heart disease and may be a therapeutic target for
right ventricular dysfunction. Previously, autologous skeletal myoblast patch
therapy showed an angiogenic effect for
left ventricular dysfunction through
cytokine paracrine effects; however, its efficacy in
right ventricular dysfunction has not been evaluated. Thus, this study aimed to evaluate the angiogenic effect of autologous skeletal myoblast patch
therapy and amelioration of metabolic and functional dysfunction, in a pressure-overloaded right heart porcine model.
Pulmonary artery stenosis was induced by a vascular occluder in minipigs; after two months, autologous skeletal myoblast patch implantation on the right ventricular free wall was performed (n = 6). The control minipigs underwent a
sham operation (n = 6). The autologous skeletal myoblast patch
therapy alleviated right ventricular dilatation and ameliorated right ventricular systolic and diastolic dysfunction. 11C-acetate kinetic analysis using positron emission tomography showed improvement in myocardial oxidative metabolism and myocardial flow reserve after cell patch implantation. On histopathology, a higher capillary density and vascular maturity with reduction of
myocardial ischemia were observed after patch implantation. Furthermore, analysis of
mRNA expression revealed that the angiogenic markers were upregulated, and ischemic markers were downregulated after patch implantation. Thus, autologous skeletal myoblast patch
therapy ameliorated metabolic and functional dysfunction in a pressure-overloaded right heart porcine model, by alleviating
myocardial ischemia through angiogenesis.