For the first time, a cell therapy has been successfully tested in patients with chronic heart failure due to a low ejection fraction, in whom it has improved the pumping capacity of the heart and decreased the risk of heart attack or stroke. , especially in those who presented high levels of inflammation. This is the largest trial of cell therapy in this type of patient and has been carried out by doctors and scientists from the Texas Heart Institute (USA).
The authors of this landmark clinical trial have shown that a special immunomodulatory cell type called MPCs (mesenchymal precursor cells) developed by Mesoblast Inc. has the potential for the first time to address an important factor contributing to heart failure: inflammation. Patients in the trial received the full pharmacological regimen recommended for the treatment of heart failure, suggesting that the effect of cell therapy was synergistic and additive to the latest generation drugs available.
Chronic heart failure is characterized by a progressive weakening of the heart muscle that loses its ability to pump blood. Currently, the drugs used to treat the disease are aimed at addressing the changes that occur in the heart due to the activation of complex neurohormonal pathways to compensate for deficits in cardiac function. In Spain, the prevalence of this pathology is 1.89% of the adult population, which means around 770,000 affected, according to data from a study published in the Spanish Journal of Cardiology.
MPC treatment decreased the risk of cardiovascular death, myocardial infarction, or stroke in patients with heart failure
The activation of these pathways favors the progression of the disease and sometimes patients have to be hospitalized; In addition, mortality rates are also high. MPC’s unique mechanism of action represents an alternative approach that can potentially significantly reduce high mortality, study results show, which have been published in the Journal of the American College of Cardiology.
MPC treatment protects heart cells
The Phase 3 DREAM-HF (Double-Blind Randomized Evaluation of Clinical Events with Allogeneic Mesenchymal Stem Cells in Heart Failure) trial, sponsored by Mesoblast, enrolled 565 patients with chronic heart failure, who were also receiving standard therapy. The study had a median follow-up of 30 months and was intended to examine the effects of MPC on the number of hospitalizations and major adverse cardiovascular events in heart failure.
Significant left ventricular muscle strengthening was observed in patients receiving MPC treatment during the first 12 months. And over a median follow-up of 30 months, the therapy decreased the risk of cardiovascular death, heart attack or stroke, with the greatest decrease being found in patients with increased inflammation.
Treatment with MPC reduced the rate of heart attack or stroke by 58%, and for patients with elevated levels of a blood marker of inflammation this percentage rose to 75%. The improvement in ejection fraction was also more marked in patients with higher levels of inflammation.
“The DREAM-HF results are an important step in understanding how cell therapy provides benefits in patients with chronic heart failure due to poor pump function. The cells appear to work by reducing inflammation, increasing microvascular flow, and strengthening the heart muscle. Locally, in the heart, MPCs can protect heart muscle cells from death and can improve blood flow and energy. In large blood vessels throughout the body, reduced inflammation resulting from MPC activation can decrease plaque instability, which is what leads to heart attacks and strokes. The cells appear to have a systemic anti-inflammatory and immunomodulatory effect,” explained the study’s lead author, Emerson C. Perin, MD, Texas Heart Institute Medical Director.
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