Association of electrostimulation with cell transplantation in ischemic heart disease  Abdel Shafy, MD, Thomas Lavergne, MD, Christian Latremouille, MD,

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Association of electrostimulation with cell transplantation in ischemic heart disease  Abdel Shafy, MD, Thomas Lavergne, MD, Christian Latremouille, MD, PhD, Miguel Cortes-Morichetti, MD, Alain Carpentier, MD, PhD, Juan C. Chachques, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 138, Issue 4, Pages 994-1001 (October 2009) DOI: 10.1016/j.jtcvs.2009.02.025 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Study design. MI, Myocardial infarction. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Explanted heart at 12 weeks of myocardial infarction, created by the ligation of the distal homonymous (equivalent to human left anterior descending) and second diagonal coronary arteries. View from the apex of the right ventricle (RV), the left ventricle (LV), and the myocardial infarction (MI). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Skeletal myoblasts after 4 weeks of in vitro culture (phase contrast, magnification ×100). B, The red asterisk shows cells that appear with a typical myoblast phenotype. The black asterisks show cells proliferating toward a myotube-like shape (magnification ×400). C, The arrows show nuclei with different morphology, from central round to peripheral elongated corresponding to different stages of skeletal muscle differentiation (magnification ×1000). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A, Echocardiographic studies. Left ventricular end-diastolic volume (LVEDV) evolution during follow-up (∗P < .01). B, Ejection fraction (EF) evolution during follow-up (∗P < .01). C, Left ventricular anterior wall thickness at diastolic phase evolution during follow-up (∗P < .01). CRT, Cardiac resynchronization therapy; LVAWd, anterior wall thickness at diastolic phase. The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 A, Histoimmunologic studies at 12 weeks in cell-treated group, showing isolated grafted myoblasts into the infarcted area. Stain with MY-32 antibody to skeletal myosin (original magnification, ×250). B, Histoimmunologic studies at 12 weeks in the cell + electrostimulation group, showing a mixture of multinucleated myotubes and fibrillar configuration. Stain with MY-32 antibody to skeletal myosin (original magnification, ×200). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Cross and longitudinal section of multinucleated myotubes (marked with 4′,6-diamidino-2-phenylindole dye) developed in the myocardial infarcted area after treatment with skeletal myoblasts associated with chronic electrostimulation (original magnification, ×360). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Left, Myoblasts organized and assembled in myofibers after pacing. Stain with antibody to slow-twitch skeletal myosin (original magnification, ×300). Right, Fibrillar configuration of myoblasts marked with 4′,6-diamidino-2-phenylindole dye in the infarcted area, group 4 (original magnification, ×320). The Journal of Thoracic and Cardiovascular Surgery 2009 138, 994-1001DOI: (10.1016/j.jtcvs.2009.02.025) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions