39th National Congress of the Italian Society of Organ TransplantationThoracic transplantationFirst Evidence of Cardiac Stem Cells From the Left Ventricular Apical Tip in Patients With Left Ventricular Assist Device Implantation

•In the last few years, regenerative medicine techniques have been increasingly investigated as potential options to treat cardiovascular disease and to restore cardiac function.•CSCs can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis.

BackgroundRecent studies have challenged the dogma that the adult heart is a postmitotic organ and raise the possibility of the existence of resident cardiac stem cells (CSCs). Our study aimed to explore if these CSCs are present in the “ventricular tip” obtained during left ventricular assist device (LVAD) implantation from patients with end-stage heart failure (HF) and the relationship with LV dysfunctional area extent.MethodsFour consecutive patients with ischemic cardiomyopathy and end-stage HF submitted to LVAD implantation were studied. The explanted “ventricular tip” was used as a sample of apical myocardial tissue for the pathological examination. Patients underwent clinical and echocardiographic examination, both standard transthoracic echocardiography (TTE) and speckle tracking echocardiography (STE), before LVAD implantation.ResultsAll patients presented severe apical dysfunction, with apical akinesis/diskinesis and very low levels of apical longitudinal strain (−3.5 ± 2.9%). Despite this, the presence of CSCs was demonstrated in pathological myocardial samples of “ventricular tip” in all 4 of the patients. It was found to be a mean of 6 c-kit cells in 10 fields magnification 40×.ConclusionsCardiac stem cells can be identified in the LV apical segment of patients who have undergone LVAD implantation despite LV apical fibrosis.