Skeletal myoblast sheet transplantation improves the diastolic function of a pressure- overloaded right heart  Takaya Hoashi, MD, Goro Matsumiya, MD, PhD,

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Skeletal myoblast sheet transplantation improves the diastolic function of a pressure- overloaded right heart  Takaya Hoashi, MD, Goro Matsumiya, MD, PhD, Shigeru Miyagawa, MD, PhD, Hajime Ichikawa, MD, PhD, Takayoshi Ueno, MD, PhD, Masamichi Ono, MD, PhD, Atsuhiro Saito, PhD, Tatsuya Shimizu, MD, PhD, Teruo Okano, MD, PhD, Naomasa Kawaguchi, PhD, Nariaki Matsuura, MD, PhD, Yoshiki Sawa, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 138, Issue 2, Pages 460-467 (August 2009) DOI: 10.1016/j.jtcvs.2009.02.018 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Representative pressure–volume loops of the control (A), sham (B), and myoblast sheet transplantation (MST; C) groups under different loading conditions. The slope of the end-systolic pressure–volume relationship is displayed as a black straight line. The correlation of the end-diastolic pressure–volume relationship is displayed as a green monoexponential curve. RVP, Right ventricular pressure; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 460-467DOI: (10.1016/j.jtcvs.2009.02.018) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Macroscopic photographs of hematoxylin and eosin–stained sections showing right ventricular (RV) wall thickening, cavity enlarging, and the intraventricular septum shifting towered the left side in the sham and myoblast sheet transplantation (MST) groups (A and D). Photomicrographs (40×, scale bar = 200 μm) of hematoxylin and eosin–stained sections showed a fibrous organized thin layer on the epicardium in the myoblast sheet transplantation group (B). Photomicrographs (400×, scale bar = 20 μm) of periodic acid–Schiff–stained sections showed significantly hypertrophied ventricular myocytes in the sham and myoblast sheet transplantation groups (C and E). ∗P < .05 (n = 10). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 460-467DOI: (10.1016/j.jtcvs.2009.02.018) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Representative photomicrographs (100×, scale bar = 100 μm) of Factor VIII–stained epicardial layer (A), mid layer (B), and endocardial layer (C). Neovascularization occurred at the epicardial layer in the myoblast sheet transplantation (MST) group (D). ∗P < .05 (n = 10). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 460-467DOI: (10.1016/j.jtcvs.2009.02.018) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Representative photomicrographs of Masson's trichrome–stained transmural layer (A; 40×, scale bar = 200 μm), epicardial layer (B), mid layer (C), and endocardial layer (D; 200×, scale bar = 50 μm) for evaluation of interstitial (E) and endomyocardial (F) fibrosis. ∗P < .05 (n = 10). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 460-467DOI: (10.1016/j.jtcvs.2009.02.018) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 RT-PCR for evaluation of neurohormonal factor gene expression. The results are expressed after normalization for GAPDH. HGF, Hepatocyte growth factor; VEGF, vascular endothelial growth factor. ∗P < .05 (n = 10). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 460-467DOI: (10.1016/j.jtcvs.2009.02.018) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions