Synergistic effects of intracoronary infusion of autologous bone marrow-derived mesenchymal stem cells and revascularization procedure on improvement of cardiac function in patients with severe ischemic cardiomyopathy.

  • Journal: Stem Cell Investig. 2021 Jan 22;8:2. doi: 10.21037/sci-2020-026
  • Authors: Sze Piaw Chin¹,², Oteh Maskon³, Chiang Soo Tan⁴, John E Anderson⁴, Chee Yin Wong¹, Hamat Hamdi Che Hassan³, Chee Ken Choor³, S Abdul Wahid Fadilah⁵, Soon Keng Cheong¹,⁶

Background

Ischemic cardiomyopathy (ICM) is a leading cause of cardiovascular mortality worldwide. It is defined as abnormal enlargement of the left ventricular (LV) cavity with poor LV function due to coronary artery disease. Currently available established treatments are palliative whereby blood supply is recovered to ischemic regions but fails to regenerate heart tissues. Mesenchymal stem cells (MSCs) offer a promising treatment for ICM given their regenerative and multipotent characteristics. This study aims to investigate the effect of MSCs infusion with concurrent revascularization in patients with severe ICM compared to receiving only revascularization procedure or MSCs infusion.

Methods

Twenty-seven patients with history of anterior myocardial infarction (MI) and baseline left ventricular ejection fraction (LVEF) of less than 35% were recruited into this study. Patients who are eligible for revascularization were grouped into group A (MSCs infusion with concurrent revascularization) or group B (revascularization only) while patients who were not eligible for revascularization were allocated in group C to receive intracoronary MSCs infusion. LV function was measured using echocardiography.

Results

Patients who received MSCs infusion (either with or without revascularization) demonstrated significant LVEF improvements at 3, 6 and 12 months post-infusion when compared to baseline LVEF within its own group. When comparing the groups, the magnitude of change in LVEF from baseline for third visits i.e., 12 months post-infusion was significant for patients who received MSCs infusion plus concurrent revascularization in comparison to patients who only had the revascularization procedure.

Conclusion

MSCs infusion significantly improves LV function in ICM patients. MSCs infusion plus concurrent revascularization procedure worked synergistically to improve cardiac function in patients with severe ICM.

Keywords

Intracoronary, ischemic cardiomyopathy (ICM), mesenchymal stem cell (MSC), revascularization

Affiliations 

  1. Cytopeutics, Selangor, Malaysia.
  2. CMH Specialist Hospital, Negeri Sembilan, Malaysia.
  3. Cardiology Unit, Department of Medicine, Universiti Kebangsaan Malaysia MedicalCentre, Kuala Lumpur, Malaysia.
  4. Adventist Heart Centre, Penang Adventist Hospital, Penang, Malaysia.
  5. Cell Therapy Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
  6. Faculty of Medicine and Health Sciences, Tunku Abdul Rahman University, Selangor, Malaysia.
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