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Stem Cell Therapy Prompts 'Unprecedented' Myocardial Regeneration After MI

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'Striking' Evidence of Cardiac Regeneration

From the report by Dr. Makkar and colleagues, "we can conclude that cardiosphere-derived cell harvesting and intracoronary delivery are feasible in patients with recent MI, but investigations involving more patients, longer follow-up, and a true placebo arm will be needed to confirm the safety and efficacy" of the treatment, said Dr. Chung-Wah Siu and Dr. Hug-Fat Tse.

The MRI imaging provided striking evidence of cardiac regeneration, with a reduction of 28% in average scar mass at 6 months and 42% at 12 months, they noted.

Dr. Siu and Dr. Tse are in the division of cardiology and the research center of the heart, brain, hormone, and healthy aging at the University of Hong Kong. They declared that they had no financial conflicts of interest (Lancet 2012 Feb. 14 [doi: 10.1016/S0140-6736(12)60236-0]).


 

FROM THE LANCET

However, scores on the Minnesota Living with Heart Failure Questionnaire decreased to the same degree in the two study groups. And both groups also showed nonsignificant changes in left-ventricular ejection fraction at 6 months.

Both regional contractility and systolic wall thickening improved in the stem cell group but worsened in the control group.

Previous studies have reported small reductions in scar size after infusions of bone marrow mononuclear cells, mesenchymal cells, and another heart-derived cell product, purified c-KIT–positive cells. However, animal studies demonstrate that the cardiosphere-derived cells used in this study outperform all of them "in terms of paracrine potency, antiapoptotic properties, tissue engraftment, and regenerative efficacy," the CADUCEUS researchers said.

"This discovery challenges the conventional wisdom that, once established, cardiac scarring is permanent and that, once lost, healthy heart muscle cannot be restored," they concluded.

CADUCEUS was supported by the National Heart, Lung, and Blood Institute and Cedars-Sinai Heart Stem Cell Center. Dr. Makkar’s associates reported ties to Capricor, a biotech company that develops and commercializes cardiac stem cell treatments.

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