Key result
Mesenchymal stem cells improve 1-year 6-minute walk distance in ischemic cardiomyopathy regardless of age.
Why the study?
The role of patient age in the efficacy of mesenchymal stem cell therapy for ischemic cardiomyopathy is controversial, and it was uncertain whether the therapeutic effect of culture-expanded MSCs persists in older subjects.
Does recipient age (≥60 years vs. <60 years) impair improvements in functional capacity, quality of life, and reverse remodeling following transendocardial mesenchymal stem cell injection in patients with ischemic cardiomyopathy?
Cohort (n=49)
Does recipient age (≥60 years vs. <60 years) impair improvements in functional capacity, quality of life, and reverse remodeling following transendocardial mesenchymal stem cell injection in patients with ischemic cardiomyopathy?
Older patients (≥60 years) with chronic ischemic cardiomyopathy derive similar improvements in 6-minute walk distance, quality of life, and myocardial scar reduction from transendocardial mesenchymal stem cell therapy as patients younger than 60 years.
BACKGROUND: The role of patient age on the efficacy of mesenchymal stem cell (MSC) therapy in ischemic cardiomyopathy (ICM) is controversial. OBJECTIVE: We sought to determine whether the therapeutic effect of culture-expanded MSCs persists even in older subjects. METHODS: Patients with ICM who received MSCs via transendocardial stem cell injection (TESI) as part of the TAC-HFT (n = 19) and POSEIDON (N = 30) clinical trials were divided into 2 age groups: <60 versus ≥60 years. Functional capacity was measured by 6-minute walk distance (6MWD) and quality of life using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, measured at baseline, 6 months, and 1-year post-TESI. Various cardiac imaging parameters, including absolute scar size, were compared at baseline and 1 year post-TESI. RESULTS: Mean 6MWD was similar at baseline and increased at 1 year post-TESI in both groups: 48.5 ± 14.6 m (p = 0.001) for the younger and 35.9 ± 18.3 m (p = 0.038) for the older participants (p = NS between groups). The older group exhibited a significant reduction in MLHFQ score (−7.04 ± 3.54; p = 0.022), while the <60 age group had a borderline significant reduction (−11.22 ± 5.24; p = 0.058) from baseline (p = NS between groups). While there were significant reductions in absolute scar size from baseline to 1 year post-TESI, the effect did not differ by age. CONCLUSION: MSC therapy via TESI in ICM patients improves 6MWD and MLHFQ score and reduces MI size. Importantly, age did not impair response.
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Golpanian et al. (2015) conducted a cohort in Ischemic cardiomyopathy (ICM) (n=49). Recipient age ≥60 years undergoing transendocardial human mesenchymal stem cell (hMSC) injection vs. Recipient age <60 years undergoing transendocardial hMSC injection was evaluated on Change in 6-minute walk distance (6MWD) at 1 year post-transendocardial stem cell injection (MD 18.61, 95% CI 15.95 to 53.17, p=0.2882). Mesenchymal stem cell therapy improved 1-year 6-minute walk distance in both older (+35.9 m, p=0.038) and younger (+48.5 m, p=0.001) ischemic cardiomyopathy patients without difference by age.
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