Autologous MSC infusion improves ejection fraction and wall thickness in severe ischemic cardiomyopathy: Results from a clinical multicenter phase ll/lll randomized controlled trial.

  • Journal: Cytotherapy Volume 18, Issue 6, Supplement S25 June 2016
  • Authors: C. Tan, J.E. Anderson, O. Maskon, S. Chin, H. Che Hassan, C. Choor S.K. Paul, N. Abu Bakar, N. Azreen, N. Amran@Azman, Z. Ismahadi, L. Qizhou, S. Cheong, S.S. Abdul Wahid

Background

We have previously demonstrated that mesenchymal stromal cell (MSC) may improve cardiac function and reduce scar tissue in end-stage cardiomyopathy when administered concurrently with revascularization (either cardiac bypass operation or coronary angioplasty). In this study we compared the effects of MSC with concurrent revascularization (Group A), MSC only (Group B) and revascularization only (Group C).

Methods

Twenty-seven patients were recruited. All patients had anterior myocardial infarction previously and baseline cardiac function (left ventricular ejection fraction, LVEF) less than 40%.   Patients who were suitable for revascularization were divided into Group A or C. Patients who have had revascularization previously or were unsuitable for revascularization were allocated to receive MSC by intracoronary infusion (Group B). Patients received between 50-100×10° autologous bone-marrow MSC. The LVEF, LV end diastolic diameter (LVEDD) and interventricular septum thickness (IVST) were estimated at baseline, 3 months, 6 months and 12 months follow-up. Magnitude of change in LVEF (AEF) was calculated as percentage of baseline value.

Results

All patients patients tolerated tolerate the procedure well with no proarrythmia, calcification or tumor formation. There was no difference in baseline parameters between Groups A, B and C including LVEF (27.5+5.6 vs. 32.0+4.5 vs. 28.0±8.3%; p=0.26). LVEF improved in groups A and B during follow-up. The improvements were statistically significant compared to baseline for Group B at 3 months and for Groups A and C at 6 months. The AEF was largest in Group A compared to Groups B and B and C at 12 months (130±83 vs. 46+37 vs. 31±29%; ANOVA p=0.02).

Conclusion

MSC significantly improves cardiac function. Concurrent MSC administration with revascularization appeared to be superior to either procedure alone for patients with ischemic cardiomyopathy.

Affiliations

  1. Penang Adventist Hospital, Penang, Malaysia
  2. Cardiology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  3. Cytopeutics, Selangor, Malaysia
  4. Radiology Unit, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  5. Department of Medicine, The University of Hong Kong, Hong Kong
  6. Tunku Abdul Rahman University, Selangor, Malaysia
  7. Cell Therapy Center, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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