More than six million Americans suffer from chronic heart failure, a disease that progressively weakens the heart’s muscle and destroys its ability to pump enough oxygen and blood to other organs.
However, results from the largest clinical trial of its kind offer hope to those with the disease, who up until now have relied largely on drugs that work on the heart’s complex neuralhormonal pathways but have done little to lower the mortality rate in time.
Physician-scientists at The Texas Heart Institute have shown that a new approach to heart failure, using cell therapy to combat one of the disease’s lead culprits – inflammation – can have a dramatic impact on the outcomes of sufferers.
In the phase 3 DREAM-HF trial, performed across 51 sites and involving 565 patients on medication for chronic heart failure, non-placebo recipients received a single transendocardial administration of mesenchymal precursor cells (MPC), then had a baseline and 12-month echocardiography performed.
Patients receiving the MPC cells, which were obtained from the bone marrow of healthy donors and developed by Australian biotech company Mesoblast, showed a significant strengthening of the left ventricular muscle and its pumping ability during that first 12 months. Thirty months on from the initial treatment, MPC therapy reduced the rate of heart attack or stroke by 58%, with this figure rising to 75% for those with high levels of an inflammation blood marker.
“The results of DREAM-HF are an important step in understanding how cell therapy provides benefits in patients with chronic heart failure due to poor pump function,” said Dr Emerson C. Perin, Medical Director at The Texas Heart Institute and the lead author of the study. “The cells appear to work by reducing inflammation, increasing microvascular flow, and strengthening heart muscle.”
The improvement in left ventricular ejection fraction – which measures heart pumping abilities – in patients with high levels of inflammation proved particularly pleasing for researchers who believe cell therapy is the next frontier in tackling this cardiovascular disease.
“The cells seem to have a systemic immune-modulatory and anti-inflammatory effect,” said Dr Perin. “Locally, in the heart, the MPCs can protect cardiac muscle cells from dying and can improve blood flow and energetics. In large blood vessels throughout the body, the reduced inflammation resulting from the activation of MPCs may decrease plaque instability, which is what leads to heart attacks and strokes.”
While heart failure accounts for around 8.5% of all heart disease deaths each year, its symptoms are often mistaken for the normal signs of aging. Those with high blood pressure, diabetes, obesity, heart defects, lung disease and sleep apnea face a higher risk of developing the disease.
“MPC therapy could change the future of cardiovascular care for patients with heart failure due to inflammation,” said Dr Joseph G. Rogers, The Texas Heart Institute CEO and advanced heart failure specialist.
The study was published in the Journal of the American College of Cardiology.
Source: The Texas Heart Institute
