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(Circulation Research. 2006;98:705.)
© 2006 American Heart Association, Inc.

Integrative Physiology

Pulsatile Cardiac Tissue Grafts Using a Novel Three-Dimensional Cell Sheet Manipulation Technique Functionally Integrates With the Host Heart, In Vivo

Akira Furuta, Shunichiro Miyoshi, Yuji Itabashi, Tatsuya Shimizu, Shinichiro Kira, Keiko Hayakawa, Nobuhiro Nishiyama, Kojiro Tanimoto, Yoko Hagiwara, Toshiaki Satoh, Keiichi Fukuda, Teruo Okano, Satoshi Ogawa

From the Cardiopulmonary Division (A.F., S.M., Y.I., S.K., K.H., N.N., K.T., Y.H., T. Satoh, S.O.), Department of Internal Medicine; and Institute for Advanced Cardiac Therapeutics (S.M.), Keio University School of Medicine; Institute of Advanced Biomedical Engineering and Science (T. Shimizu, T.O.), Tokyo Women’s Medical University; and Department of Regenerative Medicine and Advanced Cardiac Therapeutics (K.F.), Keio University School of Medicine, Japan.

Correspondence to Shunichiro Miyoshi, MD, PhD, Institute for Advanced Cardiac Therapeutics, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan. E-mail smiyoshi{at}cpnet.med.keio.ac.jp

We devised a method of fabricating easily transplantable scaffoldless 3D heart tissue, made with a novel cell-sheet (CS) technology from cultured cardiomyocytes using a fibrin polymer coated dish. In the present study, we tested in vivo electrical communication which is essential for improving heart function between the host heart and the grafted CS. The epicardial surface of the ventricle of an anesthetized open-chest nude rat was ablated by applying a heated metal. Bilayered CS was obtained from neonatal rat primary culture. CS was transplanted onto the injured myocardial surface (sMI) (sMI+sheet group). The rats were allowed to recover for 1 to 4 weeks, to stabilize the grafts. Action potentials (APs) from the excised perfused heart were monitored by the fluorescence signal of di-4ANEPPS with a high speed charge-coupled device camera. The APs were observed under epicardial pacing of the host heart or the CS grafts. The pacing threshold of the current output was measured in the sMI+sheet group and in the nongrafted sMI group at the center of the sMI and in the normal zone (Nz). Bidirectional AP propagation between the sMI and Nz was observed in the sMI+sheet group (n=14), but was blocked at the marginal area of the sMI in the sMI group (n=9). The ratio of the pacing threshold (sMI/Nz) was significantly lower in the sMI+sheet than in the sMI group (3.0±0.7, 19.0±6.1 respectively P<0.05). There were neither spontaneous nor pacing-induced arrhythmias in these two groups. Bidirectional smooth AP propagation between the host heart and the grafted CS was observed. This finding suggested functional integration of this CS graft with the host heart without serious arrhythmia.

Key Words: stem cell-based therapy • regenerative medicine • cardiac transplantation • electrophysiology • arrhythmia

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