Novel regenerative therapy using cell-sheet covered with omentum flap delivers a huge number of cells in a porcine myocardial infarction model Yasuhiro.

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Novel regenerative therapy using cell-sheet covered with omentum flap delivers a huge number of cells in a porcine myocardial infarction model Yasuhiro Shudo, MD, Shigeru Miyagawa, MD, PhD, Satsuki Fukushima, MD, PhD, Atsuhiro Saito, PhD, Tatsuya Shimizu, MD, PhD, Teruo Okano, PhD, Yoshiki Sawa, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 5, Pages 1188-1196 (November 2011) DOI: 10.1016/j.jtcvs.2011.07.002 Copyright © 2011 Terms and Conditions

Figure 1 Study protocol for the assessment of cardiac function and histologic analysis. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 2 Macroscopic (×40) views of the heart in the 4 groups (hematoxylin–eosin staining). SO group, skeletal myoblast (SMB) sheets wrapped with omentum; S group, SMB sheets only; O group, omentum only; sham group, sham operation. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 3 Macroscopic (×40) views of the heart in the 4 groups (Masson trichrome staining). Infarct area: The SO group showed a significant improvement in the infarct area of the whole heart. Abbreviations as in Figure 2. ∗P < .05. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 4 Microscopic (×200) views of sections of the peri-infarct border-zone region stained with the von Willebrand factor antibody (factor VIII) in the 4 groups (bar = 20 μm). Vascular density: The SO group showed a significant improvement in vascular density, as assessed by anti–von Willebrand factor antibody. Abbreviations as Figure 2. N > 4 in each group. ∗P < .05. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 5 A, Microscopic (×200) views of the infarct region in the SO group (alpha smooth muscle actin staining). B, Microscopic (×200) views of the infarct region in the SO group (vimentin staining). C, Microscopic (×200) views of the infarct region in the SO group (fast type myosin heavy chain staining). D and E, Microscopic (×200) views of the heart (desmin staining). SO group, SMB sheets wrapped with omentum. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 6 mRNA expressions in implanted infarcted hearts were determined by real-time PCR using porcine primers. The expressions of vascular endothelial growth factor (VEGF) and signal transducer and activator of transcription 3 (STAT3) mRNA were significantly increased in the SO group compared with the other groups. Abbreviations as in Figure 2. N > 4 in each group. ∗P < .05. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions

Figure 7 Echocardiographic analysis. The SO group showed less ventricular remodeling and greater degrees of improved anterior wall thickness and cardiac function than did the S group. Pink line, SO group; red line, S group; blue line, O group; green line, sham group; LVEDV, left ventricular end-diastolic volume; LVESV, left ventricular end-systolic volume; LVEF, left ventricular ejection fraction; other abbreviations as in Figure 2. N = 6 in each group. ∗P < .05. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1188-1196DOI: (10.1016/j.jtcvs.2011.07.002) Copyright © 2011 Terms and Conditions