The results of the largest cell therapy study in patients with heart failure to date have been announced by physician-scientists at The Texas Heart Institute. All rights reserved
Patients with chronic heart failure may benefit from a new cell therapy.
The largest cell therapy study to date in chronic heart failure due to low ejection fraction was announced today. This improved patients' heart's pumping ability, as measured by ejection fraction, and decreased the risk of cardiovascular death, especially in patients who have high inflammation. The findings will be published today (February 27, 2023) in the Journal of the American College of Cardiology.
MPC (mesenchymal precursor cells), developed by Mesoblast Inc., has the potential for the first time to address a major contributor to cardiac failure—inflammation, according to researchers. The cell therapy was beneficial to and complementary to state-of-the-art heart failure medications.
The DREAM-HF findings on long-term improvement in outcomes for patients with heart failure are an important milestone in the field of cardiac cell therapy. The findings will be used to design definitive clinical studies for examining cell therapy in patients with heart disease and may help in identifying those most likely to benefit from MPC therapy.
Chronic heart failure is a progressive illness that results in a decrease in the heart muscle and a loss of its pumping capacity. Most heart failure medications currently used address the detrimental changes that occur in the heart as a result of complex neurohormonal pathways that are activated during heart failure.
Despite advances in medicine targeting these pathways, mortality rates remain high. MPC's unique mechanism of action suggests a novel approach that has the potential to significantly reduce the severity of this disease.
DREAM-HF (Double-Blind Randomized Assessment of Clinical Events With Allogeneic Mesenchymal Precursor Cells in Heart Failure), sponsored by Mesoblast, was a phase 3 study conducted at 51 sites in 565 patients with chronic heart failure who were also on standard-of-care heart failure therapy. The aim of the study was to investigate the effect of immunoselected, culture-expanded mesenchymal precursor cells (MPCs) on the number of hospitalizations
MPCs are a good choice for cardiac failure with a low ejection fraction due to their potent anti-inflammatory, pro-angiogenic, and pro-healing abilities. Cell-treated patients in the study received direct cardiac injections of MPCs, while control patients received a "sham" or mock procedure with no injections.
The authors of the landmark clinical study Dream-HF have demonstrated that cardiac stem cell therapy might provide additional advantages to medication therapy by for the first time, treating a major contributor to heart failure—inflammation. Credit: Copyright Texas Heart Institute
MPC-treated patients showed a significant improvement in the left ventricular muscle within the first 12 months, as measured by an increase in the left ventricular ejection fraction, which is one of the main measures used to evaluate overall heart function.
In patients with high inflammation levels, MPC therapy reduced the rate of heart attack or stroke by 58%, and the benefit increased to 75% in patients with elevated inflammation levels. Unlike traditional medications, MPC therapy did not significantly reduce recurrent heart failure events that required hospitalization due to the maladaptive effects of neurohormonal activation.
Emerson Perin, MD, PhD of the Texas Heart Institute, has published the findings of the largest cell therapy study in patients with heart failure to date. The treatment reduced the risk of heart attack and stroke, as well as improving the heart's ejection fraction, especially in patients who have high inflammation.
According to the study's lead author, Dr. Emerson C. Perin, PhD, FACC, a systemic immune-modulatory and anti-inflammatory action.
The results of DREAM-HF's long-term improvement in outcomes for chronic heart failure due to low ejection fraction and poor pump function are an important milestone in the field of cell therapy for cardiovascular disease. The findings will be repeated in future studies.
According to Dr. Joseph G. Rogers, the Texas Heart Institute has spent two decades pioneering the development of heart cell therapies, and is continuing to lead the world in this groundbreaking research. For millions of people in the United States over the age of 20, MPC therapy may transform the future of cardiovascular care for patients with heart failure due to inflammation.
Reference: "Randomized trial of targeted transendocardial mesenchymal precursor cell therapy in patients with heart failure" 27 February 2023, Journal of the American College of Cardiology. DOI: 10.1016/j.jacc.2022.11.061
