Hybrid surgical angiogenesis: Omentopexy can enhance myocardial angiogenesis induced by cell therapy
Hybrid surgical angiogenesis: Omentopexy can enhance myocardial angiogenesis induced by cell therapy
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DOI：
10.1016/j.athoracsur.2005.07.021
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发表时间：
2006-01-01
影响因子：
4.6
通讯作者：
Koshida, Y
中科院分区：
文献类型：
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作者：
Kanamori, T;Watanabe, G;Koshida, Y
背景在严重缺血性心脏病的细胞移植中，注射部位的条件是重要的。大网膜是一种血管化良好的组织，也是血管生成因子的来源。我们在一个大型动物模型中检测了自体骨髓来源的单核细胞（BM-MNCs）联合或不联合网膜固定术的有效性。结扎小型猪冠状动脉分支，造成侧壁心肌梗死。动物接受BM-MNC注射，伴或不伴网膜固定术。对照组仅接受生理盐水。术后3周，测量局部心肌血流量和收缩力，免疫组织化学评价小动脉密度。通过血管造影和尸检确定侧支循环。局部心肌收缩力在有和没有网膜固定的BM-MNC移植中均得到显著改善（分别为0.29 +/- 0.02 vs 0.11 +/- 0.03，p < 0.01; 0.30 +/- 0.02 vs 0.12 +/- 0.01，p < 0.01）。联合网膜固定术组的相对局部心肌血流量在静息时（1.05 ± 0.11 vs 0.57 ± 0.07，p < 0.01）和应激时（1.09 ± 0.08 vs 0.40 ± 0.10，p < 0.01）均显著高于对照组。两组的小动脉（< 50 μ m）数量均高于对照组（分别为88.1 +/- 5.00 vs 38.1 +/- 8.99，p < 0.01和109.2 +/- 9.91 vs 38.1 +/- 8.99，p < 0.01）。联合网膜固定术组的大动脉（> 50 μ m）数量显著高于单独BM-MNC组（26.9 +/- 2.4 vs 17.6 +/- 1.8，p = 0.011）和对照组（26.9 +/- 2.4 vs 10.0 +/- 1.3，p < 0.01）。大网膜与心肌间的侧支交通通过血管造影和死后注射证实。骨髓单个核细胞移植可减轻心肌收缩功能障碍，网膜固定可增强骨髓单个核细胞移植诱导的血管新生。
Background. The conditions at the injection site are important in Cell transplantation for severe ischemic heart disease. The omentum is both a well-vascularized tissue and a source of angiogenic factors. We examined the effectiveness of autologous bone marrow-derived mononuclear cells (BM-MNCs) with or without omentopexy in a large animal model.Methods. Myocardial infarction was generated in the lateral wall by ligation of coronary artery branches in miniswine. Animals received BM-MNC injection with or without omentopexy. Controls received saline only. Three weeks after surgery, regional myocardial blood flow and contractility were measured, and density of arterioles was evaluated immunohistologically. Angiography and postmortem examinations were performed to determine collateral communication.Results. Regional myocardial contractility was significantly improved by BM-MNC transplantation both with and without omentopexy (0.29 +/- 0.02 vs 0.11 +/- 0.03, p < 0.01, 0.30 +/- 0.02 vs 0.12 +/- 0.01, p < 0.01, respectively). Relative regional myocardial blood flow in the combined omentopexy group was significantly higher than the controls both at rest (1.05 +/- 0.11 vs 0.57 +/- 0.07, p < 0.01) and under stress (1.09 +/- 0.08 vs 0.40 +/- 0.10, p < 0.01). The number of arterioles (< 50 mu m) in both groups were higher than the controls (88.1 +/- 5.00 vs 38.1 +/- 8.99, p < 0.01 and 109.2 +/- 9.91 vs 38.1 +/- 8.99, p < 0.01, respectively). The number of large arterioles (> 50 mu m) in the combined omentopexy group was significantly higher than in both BM-MNC alone (26.9 +/- 2.4 vs 17.6 +/- 1.8, p = 0.011) and controls (26.9 +/- 2.4 vs 10.0 +/- 1.3, p < 0.01). Collateral communication between the omentum and myocardium was demonstrated by angiography and postmortem injection.Conclusions. The BM-MNC transplantation may attenuate cardiac contractile dysfunction, and omentopexy may enhance angiogenesis induced by BM-MNC transplantation.