Heart Disease

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

Stem Cell Investigation 2021;8:2 | https://sci.amegroups.com/article/view/61017/html

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 

1 Cytopeutics, Selangor, Malaysia; 2 CMH Specialist Hospital, Negeri Sembilan, Malaysia; 3 Cardiology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 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. 

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.

Methodology: 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.

Conclusions: 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.

自体MSC输注改善严重缺血性心脏病的心室射血分数与心壁厚度:综合临床 中心第二期/三期的随机对照试验的结果

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 

1 世德生物技术有限公司 (Cytopeutics), 马来西亚;2 森华医疗中心,马来西亚; 3 马来西亚国民大学医疗中心医学院心脏病 科; 4 槟安医院;5 马来西亚国民大学医疗中心医学院细胞治疗中心; 6 马来西亚拉曼大学 

mean of lvef (heart function)

Baseline 3 months 6 months 12 months Figure 1: Comparison of mean of LVEF within groups at baseline, 3, 6 and 12 months visit. For patients in group A and C, LVEF showed significant improvement for all post-treatment visits when comparing to baseline. Significant values: #, P<0.05; *, P<0.01. LVEF, left ventricular ejection fraction.

Figure 2: Comparison between three groups for the magnitude of change of LVEF compared to baseline during 3, 6 and 12 months visits. Magnitude of change is significant at the 12 months post-treatment visit when comparing between group A and B. LVEF, left ventricular ejection fraction; MSC, mesenchymal stem cell.