Treatment With Autologous Skeletal Myoblasts

Study Overview
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Brief Summary
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The purpose of this study is to determine the benefit of autologous skeletal myoblast injection in patients with old myocardial infarction and ventricular dysfunction versus conventional revascularisation therapy.

Detailed Description
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Ischaemic heart disease is one of the main causes of mortality and morbidity. In particular, myocardial infarction (MI) is of special significance, as the heart muscle cannot regenerate so a region's necrosis leads to the formation of a fibrous scar. Depending on the area affected by the scar, infarction can lead to a progressive and irreversible decline in cardiac function, giving way to heart failure (HF) syndrome. The molecular basis of congestive heart failure is the absence of cardiac stem cells capable of regenerating cardiac muscle. In the skeletal muscle, there are cells located beneath the basal membrane with are capable of regenerating muscle fibres; they are known as myoblasts. There are several studies with autologous myoblasts, either by direct administration during surgery or percutaneously, which could distinguish between the effect of revascularisation surgery and that of the myoblast injection. The objective of this study is compare improvement in global and regional cardiac function in patients with old MI obtained by aortocoronary bypass surgery with intracardiac administration of autologous skeletal myoblasts versus standard aortocoronary bypass surgery treatment.

Official Title
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Phase II, Randomised, Controlled Study of Treatment With Revascularisation Surgery With or Without Injection of Autologous Skeletal Myoblasts in Patients With Old Myocardial Infarction

Conditions
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Old Myocardial Infarction

Intervention / Treatment
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* Procedure: Intra-lesion injection of autologous skeletal myoblasts
* Procedure: Revascularisation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with a diagnosis of coronary disease obtained by coronary angiography who require conventional aortocoronary bypass surgery. History of myocardial infarction with evidence of regional akinesis (or dyskinesia) for more than 4 weeks and less than 10 years. Ejection fraction from 25% to 45%. Evidence of no regional viability by dobutamine echocardiography. Aged from 30-80 years old. Negative serology to HIV, HBV and HCV. Patients without organ dysfunction. Negative pregnancy test (women of childbearing age). Informed consent granted. Exclusion Criteria: History of myocardial infarction in the 4 weeks prior to the inclusion in the study. Prior history of tachycardia or ventricular fibrillation (except in patients with DAI device). History of cancer (except basocellular carcinoma) or prior treatment with chemotherapy. The patient should not suffer from any concomitant severe and/or uncontrolled medical condition. Patients who, due to their geographical, psychiatric or social status, have difficulties in meeting the conditions established in the protocol. Pregnant or beast feeding women.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Skeletal myoblasts<br>Patients who are receiving skeletal myoblasts | Procedure: Intra-lesion injection of autologous skeletal myoblasts<br>* Intra-lesion injection<br>Procedure: Revascularisation<br>* Revascularisation surgery<br>|
| Placebo Comparator: Placebo<br>Revascularisation surgery | Procedure: Revascularisation<br>* Revascularisation surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The primary efficacy endpoints will be evaluate the ejection fraction and wall motion score index measured by M-mode and echocardiography 12 months after surgery. |  | 12 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary efficacy endpoints are viability, perfusion and thickening and incidence of cardiac arrhythmias. |  | 12 month after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intra-lesion injection of autologous myoblasts