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Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the arrhythmic safety profile of the adipose graft transposition procedure (AGTP) and its electrophysiological effects on post-myocardial infarction (MI) scar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Myocardial repair is a promising treatment for patients with MI. The AGTP is a cardiac reparative therapy that reduces infarct size and improves cardiac function. The impact of AGTP on arrhythmogenesis has not been addressed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MI was induced in 20 swine. Contrast-enhanced magnetic resonance (ce-MRI), electrophysiological study (EPS), and left-ventricular endocardial high-density mapping were performed 15 days post-MI. Animals were randomized 1:1 to AGTP or sham-surgery group and monitored with ECG-Holter. Repeat EPS, endocardial mapping, and ce-MRI were performed 30 days post-intervention. Myocardial SERCA2, Connexin-43 (Cx43), Ryanodine receptor-2 (RyR2), and cardiac troponin-I (cTnI) gene and protein expression were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The AGTP group showed a significant reduction of the total infarct scar, border zone and dense scar mass by ce-MRI (<jats:italic>p<\/jats:italic> = 0.04), and a decreased total scar and border zone area in bipolar voltage mapping (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). AGTP treatment significantly reduced the area of very-slow conduction velocity (&amp;lt;0.2 m\/s) (<jats:italic>p<\/jats:italic> = 0.002), the number of deceleration zones (<jats:italic>p<\/jats:italic> = 0.029), and the area of fractionated electrograms (<jats:italic>p<\/jats:italic> = 0.005). No differences were detected in number of induced or spontaneous ventricular arrhythmias at EPS and Holter-monitoring. SERCA2, Cx43, and RyR2 gene expression were decreased in the infarct core of AGTP-treated animals (<jats:italic>p<\/jats:italic> = 0.021, <jats:italic>p<\/jats:italic> = 0.018, <jats:italic>p<\/jats:italic> = 0.051, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AGTP is a safe reparative therapy in terms of arrhythmic risk and provides additional protective effect against adverse electrophysiological remodeling in ischemic heart disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.983001","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T05:21:38Z","timestamp":1663651298000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Electrophysiological effects of adipose graft transposition procedure (AGTP) on the post-myocardial infarction scar: A multimodal characterization of arrhythmogenic substrate"],"prefix":"10.3389","volume":"9","author":[{"given":"Raquel","family":"Adeli\u00f1o","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daina","family":"Mart\u00ednez-Falguera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Curiel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Teis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Marsal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriol","family":"Rodr\u00edguez-Leor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Prat-Vidal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar","family":"Fadeuilhe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00falia","family":"Arany\u00f3","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Revuelta-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel","family":"Sarrias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edctor","family":"Bazan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan F.","family":"Andr\u00e9s-Cord\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Roura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Villuendas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Lup\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Bayes-Genis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"G\u00e1lvez-Mont\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Bisbal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/eurheartj\/ehz859","article-title":"European Society of Cardiology: cardiovascular disease statistics 2019.","volume":"41","author":"Timmis","year":"2020","journal-title":"Eur Heart J."},{"journal-title":"Mortality","year":"2022","key":"B2"},{"key":"B3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/cvr\/cvr136","article-title":"Transposition of a pericardial-derived vascular adipose flap for myocardial salvage after infarct.","volume":"91","author":"G\u00e1lvez-Mont\u00f3n","year":"2011","journal-title":"Cardiovasc Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.ijcard.2011.11.019","article-title":"Post-infarction scar coverage using a pericardial-derived vascular adipose flap. 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