This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kochupura, P. V. Articles by Gaudette, G. R. Search for Related Content PubMed PubMed Citation Articles by Kochupura, P. V. Articles by Gaudette, G. R. Related Collections Other heart failure CV surgery: transplantation, ventricular assistance, cardiomyopathy

(Circulation. 2005;112:I-144 – I-149.)
© 2005 American Heart Association, Inc.

Cell Transplantation and Tissue Engineering

Tissue-Engineered Myocardial Patch Derived From Extracellular Matrix Provides Regional Mechanical Function

Paul V. Kochupura, MD; Evren U. Azeloglu, MS; Damon J. Kelly, MS; Sergey V. Doronin, PhD; Stephen F. Badylak, MD, PhD, DVM; Irvin B. Krukenkamp, MD; Ira S. Cohen, MD, PhD; Glenn R. Gaudette, PhD

From the Departments of Surgery (P.V.K., I.B.K., G.R.G.) and Biomedical Engineering (E.U.A., D.J.K., I.B.K., G.R.G.), Stony Brook University, Stony Brook, New York; the McGowen Institute for Regenerative Medicine (S.F.B.), Pittsburgh, Pa; the Institute of Molecular Cardiology (S.V.D., I.B.K., I.S.C., G.R.G.), Stony Brook, New York; and the Department of Surgery (G.R.G.), University of Massachusetts Medical School, Worcester, Mass.

Correspondence to Glenn R. Gaudette, PhD, Department of Surgery, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655. E-mail glenn.gaudette{at}umassmed.edu

Background— Extracellular matrix (ECM), a tissue-engineered scaffold, recently demonstrated cardiomyocyte population after myocardial implantation. Surgical restoration of myocardium frequently uses Dacron as a myocardial patch. We hypothesized that an ECM-derived myocardial patch would provide a mechanical benefit not seen with Dacron.

Methods and Results— Using a canine model, a full thickness defect in the right ventricle was repaired with either Dacron or ECM. A third group had no surgery and determined baseline RV function. Eight weeks later, global systolic function was assessed by the preload recruitable stroke work relationship. Regional systolic function was measured by systolic area contraction (SAC), calculated by high density mechanical mapping. Tau was used to assess global diastolic function. Recoil rate and diastolic shear were used as measures of regional diastolic function. After functional data acquisition, tissue was fixed for histological evaluation. Global systolic and diastolic functions were similar at baseline and after ECM and Dacron implantation. Regional systolic function was greater in the ECM group compared with the Dacron group (SAC: 4.1±0.9% versus –1.8±1.1, P<0.05). Regional diastolic function was also greater in the ECM group (recoil rate (° sec^–1): –44±7 versus –17±2, ECM versus Dacron; P<0.05). Immunohistochemical analysis revealed cardiomyocytes in the ECM implant region, a finding not seen with Dacron.

Conclusion— At 8 weeks, an ECM-derived tissue-engineered myocardial patch provides regional mechanical function, likely related to cardiomyocyte population. These results are in sharp contrast to Dacron, a commonly used myocardial patch.

Key Words: heart failure • surgery • mechanics • remodeling • myocytes