An autologous platelet-rich plasma hydrogel compound restores left ventricular structure, function and ameliorates adverse remodeling in a minimally invasive large animal myocardial restoration model: A translational approach. Vu and Pal "Myocardial Repair: PRP, Hydrogel and Supplements"

Thang Duc Vu, Shripad N. Pal, Lian Kah Ti, Eliana Cecilia Martinez Valencia, Abdul Jalil Rufaihah, Lieng H. Ling, Chuen Neng Lee, Arthur Mark Richards, Theo Kofidis

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Aims: Cell-based myocardial restoration has not penetrated broad clinical practice yet due to poor cell retention and survival rates.In this study, we attempt a translational, large-scale restorative but minimally invasive approach in the pig, aiming at both structurally stabilizing the left ventricular (LV) wall and enhancing function following ischemic injury. Methods and results: A myocardial infarction (MI) was created by permanent ligation of left circumflex coronary artery through a small lateral thoracotomy. Thirty-six Yorkshire pigs were randomized to receive transthoracic intramyocardial injection into both infarct and border zone areas with different compounds: 1) Hyaluronic acid-based hydrogel; 2) autologous platelet-rich plasma (PRP); 3) ascorbic acid-enriched hydrogel (50mg/L), combined with IV ibuprofen (25mg/kg) and allopurinol (25mg/kg) (cocktail group); 4) PRP and cocktail (full-compound); or 5) saline (control). The latter two groups received daily oral ibuprofen (25mg/kg) for 7 days and allopurinol (25mg/kg) for 30 days, postoperatively. Hemodynamic and echocardiographic studies were carried out at baseline, immediately after infarction and at end-point. Eight weeks after MI, the full-compound group had better LV fractional area change, ejection fraction and smaller LV dimensions than the control group. Also, dp/dtmax was significantly higher in the full-compound group when the heart rate increased from 100 bpm to 160bpm in stress tests. Blood vessel density was higher in the full-compound group, compared to the other treatment groups. Conclusions: A combination of PRP, anti-oxidant and anti-inflammatory factors with intramyocardial injection of hydrogel has the potential to structurally and functionally improve the injured heart muscle while attenuating adverse cardiac remodeling after acute myocardial infarction.

Original languageEnglish (US)
Pages (from-to)27-35
Number of pages9
JournalBiomaterials
Volume45
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Keywords

  • Antioxidants
  • Heart failure
  • Hyaluronic acid-based hydrogels
  • Left ventricular restoration
  • Myocardial infarction
  • Platelet-rich plasma

ASJC Scopus subject areas

  • Biomaterials
  • Bioengineering
  • Ceramics and Composites
  • Mechanics of Materials
  • Biophysics

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