M Cameli1, F M Righini2, S Sparla2, D Tacchini3, A Dokollari4, C G Sassi4, C Di Tommaso2, V Curci2, S Censini2, E Incampo2, F Cassano2, G Droandi4, S Bernazzali4, M Focardi2, F Ietta5, L Sartiani6, R Romagnoli5, G Marotta7, A Mugelli6, L Paulesu5, G Sani4, P Tanganelli3, M Maccherini4, S Mondillo2. 1. Department of Cardiovascular Diseases, University of Siena, Siena, Italy. Electronic address: matteo.cameli@yahoo.com. 2. Department of Cardiovascular Diseases, University of Siena, Siena, Italy. 3. Department of Pathological Anatomy, University of Siena, Siena, Italy. 4. Department of Cardiac Surgery, University of Siena, Siena, Italy. 5. Department of Life Sciences, University of Siena, Siena, Italy. 6. Department of NeuroFarBa, Centro Interuniversitario di Medicina Molecolare e Biofisica Applicata, University of Florence, Florence, Italy. 7. Department of Hematology, University of Siena, Siena, Italy.
Abstract
BACKGROUND: Recent studies have challenged the dogma that the adult heart is a postmitotic organ and raise the possibility of the existence of resident cardiac stem cells (CSCs). Our study aimed to explore if these CSCs are present in the "ventricular tip" obtained during left ventricular assist device (LVAD) implantation from patients with end-stage heart failure (HF) and the relationship with LV dysfunctional area extent. METHODS: Four consecutive patients with ischemic cardiomyopathy and end-stage HF submitted to LVAD implantation were studied. The explanted "ventricular tip" was used as a sample of apical myocardial tissue for the pathological examination. Patients underwent clinical and echocardiographic examination, both standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE), before LVAD implantation. RESULTS: All patients presented severe apical dysfunction, with apical akinesis/diskinesis and very low levels of apical longitudinal strain (-3.5 ± 2.9%). Despite this, the presence of CSCs was demonstrated in pathological myocardial samples of "ventricular tip" in all 4 of the patients. It was found to be a mean of 6 c-kit cells in 10 fields magnification 40×. CONCLUSIONS: Cardiac stem cells can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis.
BACKGROUND: Recent studies have challenged the dogma that the adult heart is a postmitotic organ and raise the possibility of the existence of resident cardiac stem cells (CSCs). Our study aimed to explore if these CSCs are present in the "ventricular tip" obtained during left ventricular assist device (LVAD) implantation from patients with end-stage heart failure (HF) and the relationship with LV dysfunctional area extent. METHODS: Four consecutive patients with ischemic cardiomyopathy and end-stage HF submitted to LVAD implantation were studied. The explanted "ventricular tip" was used as a sample of apical myocardial tissue for the pathological examination. Patients underwent clinical and echocardiographic examination, both standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE), before LVAD implantation. RESULTS: All patients presented severe apical dysfunction, with apical akinesis/diskinesis and very low levels of apical longitudinal strain (-3.5 ± 2.9%). Despite this, the presence of CSCs was demonstrated in pathological myocardial samples of "ventricular tip" in all 4 of the patients. It was found to be a mean of 6 c-kit cells in 10 fields magnification 40×. CONCLUSIONS: Cardiac stem cells can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis.
Authors: Marie Gerisch; Jan Smettan; Sabine Ebert; Maria Athelogou; Beate Brand-Saberi; Nick Spindler; Wolf C Mueller; Shibashish Giri; Augustinus Bader Journal: Front Genet Date: 2018-03-06 Impact factor: 4.599