Pre-Ischemic Autologous Mitochondrial Transplantation by Intracoronary Injection for Myocardial Protection

Abstract Objectives In this study we investigate pre-ischemic intracoronary autologous mitochondrial transplantation (MT) as a therapeutic strategy for prophylactic myocardial protection in a porcine model of regional ischemia-reperfusion injury (IRI). Methods The left coronary artery was cannulated in Yorkshire pigs (n=26). Mitochondria (1 x 109) or buffer (Vehicle, VEH) were delivered as a single bolus (MTS) or serially (10 injections over 60 minutes, MTSS). Fifteen minutes after injection, the heart was subjected to temporary regional ischemia (RI) by snaring the left anterior descending artery. After 30 minutes of RI, the snare was released, and the heart reperfused for 120 minutes. Results Coronary blood flow (CBF) and myocardial function were increased temporarily during the pre-RI period. Following 30 minutes of RI, MTS and MTSS hearts had significantly increased CBF that persisted throughout reperfusion (VEH vs MTS and MTSS, P=.04). MTS and MTSS showed significantly enhanced ejection fraction (VEH vs MTS P Conclusions Pre-ischemic MT by single or serial intracoronary injections provides prophylactic myocardial protection from IRI, significantly decreasing infarct size and enhancing global and regional function.