April 18, 1986

Conditioned skeletal muscle: new assist for failing heart?

JAMA. 1986;255(15):1977-1979. doi:10.1001/jama.1986.03370150015002

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Each year, an estimated 10,000 patients experience irreversible congestive heart failure secondary to myocardial fibrosis. All of the available therapies— digitalis and afterload reduction agents, transplants, and mechanical assist devices—have shortcomings. Now, investigators in the United States and Europe have developed modified skeletal muscles that they believe may eventually provide a fourth therapeutic alternative.

The approach involves electrically conditioning skeletal muscle to develop fatigue resistance, and then using it as autogenous grafts or ventricular assist pumps that augment aortic diastolic pressure. Proponents contend that this will circumvent rejection problems and reduce the risk and cost of heart surgery.

Skeletal muscle grafts have already been tried clinically in this country and in France. The American surgeon, George J. Magovern, MD, chief of surgery at Allegheny General Hospital, Pittsburgh, says that his patient could have lived without the muscle graft, but that it has improved her quality of life. He cautions that