Effect of Aging on Human Mesenchymal Stem Cell Therapy in Ischemic Cardiomyopathy Patients | Journal Scan

Study Questions:

Does advanced age impair efficacy of human mesenchymal stem cell (MSC) therapy for ischemic cardiomyopathy (ICM)?

Methods:

ICM subjects 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 two 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. Cardiac imaging parameters, including 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 scar size from baseline to 1 year post-TESI, the effect did not differ by age.

Conclusions:

The authors concluded that MSC therapy via TESI in ICM patients improves 6MWD and MLHFQ score and reduces myocardial infarction size. Age did not impair response.

Perspective:

Many graft and host characteristics may influence the success of MSC for ICM. For example, angiogenic responses to ischemic injury are diminished with age, which may reduce viability of implanted cells. Additionally, MSC harvested from the bone marrow of aged patients may exhibit reduced homing and proliferative capacity. Since IHD is strongly age-related, it is critical to understand the effect of age on TESI. Although the number of patients studied is relatively small, this study suggests there is no major effect of age on functional outcomes following TESI with MCS’s, and that older age groups should be included in future stem cell trials.

Clinical Topics: Heart Failure and Cardiomyopathies, Noninvasive Imaging, Acute Heart Failure

Keywords: Bone Marrow, Cardiac Imaging Techniques, Cardiomyopathies, Cicatrix, Heart Failure, Mesenchymal Stromal Cells, Myocardial Infarction, Myocardial Ischemia, Quality of Life, Stem Cell Transplantation


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