Cardiac Revascularization Post Myocardial Infarction Enhances Remuscularization and Improves Function
Bibliographic record
Abstract
Background Human induced pluripotent stem cell‐derived cardiomyocytes (hiPSC‐CMs) offer an unprecedented opportunity to remuscularize infarcted human hearts. However, studies show that the majority of hiPSC‐CMs die post transplantation into the ischemic environment, limiting their regenerative potential and clinical application. Death of transplanted CMs occurs in the first few days post‐transplantation due to ischemia. Thus, attempts have been made to promote blood perfusion (i.e. addition of endothelial cells and/or angiogenic factors). However, these approaches require weeks for new vessels to form and to carry blood compared to the rapid death of transplanted CMs (2–3 days). Purpose Our goal was to improve the vascularization of the ischemic hearts to improve the survival of hiPSC‐CMs and increase heart remuscularization and function. Methods We performed left anterior descending artery (LAD) ligation in immunocompromised rats to model myocardial infarction. To improve vascularization, we used an innovative strategy consisting of ready‐made microvessels isolated from adipose tissue that form a vasculature and carry blood within the first days post subcutaneous implantation. We have co‐implanted ready‐made microvessels with hiPSC‐CMs by intra‐myocardial injection 2 weeks post LAD ligation. Cardiac function was assessed at 0, 2 and 4 weeks post‐implantation by echocardiography and by pressure‐volume loop at the endpoint (4 weeks). Immunohistochemistry and blood perfusion studies were performed at 1 and 4 weeks post‐implantation. Results Compared to hiPSC‐CM transplantation alone, microvessels promoted a ~600% increase in hiPSC‐CM survival with significant reduction in scar size. Echocardiography and pressure–volume (PV) loop analysis performed 4 weeks post‐MI revealed that hiPSC‐CM transplantation attenuated post‐infarct ventricular dilation and enhanced left ventricular contractility by demonstrating a significant improvement in fractional shortening (FS), ejection fraction (EF) as well as other functional parameters (end‐systolic volume, end‐diastolic volume, dP/dt max and min, Tau). Remarkably, co‐transplantation of hiPSC‐CMs with microvessels showed significantly superior functional recovery compared to hiPSC‐CMs alone in all the parameters assessed. Microvessels showed remarkable persistence and integration at both early and late time points, resulting in significantly faster blood perfusion and higher vessel density in the grafts. Conclusion These findings provide a novel approach to cell‐based therapies for myocardial infarction whereby incorporation of ready‐made microvessels can serve as a personalized delivery system to improve functional outcomes in cell replacement therapies post‐myocardial infarction. Support or Funding Information Canadian Institutes of Health Research (CIHR), Institute of Circulatory and Respiratory Health grant #137352 and #PJT153160. Discovery grant from the Natural Sciences and Engineering Research Council (NESERC): RGPIN 06621‐2017.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".