First-in-man application of left ventricular augmentation for treatment of dilated cardiomyopathy

Objective: Dilated Cardiomyopathie (CMP), as a heart disease with less therapeutic resources, involves an abysmal quality of life and a premature death. Excor implantation or heart transplantation are required. After animal experiments, intramuscular injection of alginate leads to improvement of myocardial function in dilated cardiomyopathie (CMP). We report the first patient recovering their new treatment. Methods: Within mitral valve repair, 9 algisyl injections, 0.3 ml each, were applied in a horizontal median line of the left ventricle, like a "heart-waist". The selfgelling alginate ought to be intramuscular. Preliminary and follow-up examination by echocardiography and 4-D-CT were performed. Results: After alginate implantation recovery of ventricular function were recognized. Symptoms of right and left ventricular failure declined. The ejection fraction increased from 15% to 28% as well as the wall thickness of the left ventricle. Conclusion: Alginate injection improves left and subsequently right ventricular function. There is probably an alteration of the left ventricular spherical geometry in an ellipsoid geometry caused by the alginate injection. The physiological mechanism is still vague and requires further clarification of this phenomenon.