Functional Recovery after Intramyocardial Injection of Adipose-Derived Stromal Cells Assessed by Cardiac Magnetic Resonance Imaging

Abstract

Aims. A major clinical concern is the continuous increase in the number of patients diagnosed with advanced coronary artery disease, ischemic heart failure, and refractory angina, and one of the most promising treatment options for these conditions is stem cell-based therapy. The aim of this study was to assess the functional improvement following intramyocardial injection of adipose-derived stromal cells, using cardiac magnetic resonance. Methods and Results. Thirteen patients with ischemic heart failure, reduced left ventricular ejection fraction, refractory angina, and who have been disqualified from any form of direct revascularization were enrolled in the study with transthoracic autologous adipose-derived stromal cell implantation. All patients underwent cardiac magnetic resonance prior to the procedure and after 12 months of follow-up. A significant increase in stroke volume ( 83.1 ± 8.5 mL vs 93.8 ± 13.8 mL , p = 0.025 ) and stroke volume index ( 43.3 ± 7.6 mL / m 2 vs 48.7 ± 9.1 mL / m 2 , p = 0.019 ), a statistical trend toward an increase in left ventricle ejection fraction ( 36.7 ± 13.2 vs 39.7 ± 14.9 , p = 0.052 ), and cardiac output improvement ( 5.0 ± 0.7 vs 5.5 ± 0.9 , p = 0.073 ) was observed in the patient postprocedure. Enhanced relative regional thickening was noted in the segments with adipose-derived stromal cell implantation. Conclusions. Intramyocardial adipose-derived stromal cell implantation is a promising therapeutic option for selected, symptomatic patients with ischemic heart failure, who have preserved myocardial viability despite being unsuitable for direct revascularization.

Aging and Metabolic Reprogramming of Adipose-Derived Stem Cells Affect Molecular Mechanisms Related to Cardiovascular Diseases

“…ASCs delivered to thirteen patients with ischemic heart failure and refractory angina who were not qualified for any form of direct revascularization did not improve LVEF and cardiac output at 12 months of follow-up [80]. In a Danish multi-center double-blinded placebo-controlled phase II study, direct intramyocardial injections of allogeneic ASCs were safe but did not improve myocardial function, structure, or clinical symptoms [81].…”

Hybrid techniques for myocardial regeneration: state of the art and future perspectives

“…The combination of ADSCs’ direct implantation and creation of small channels using a medical laser through a left sided mini-thoracotomy was described by Konstanty-Kalandyk et al [ 31 , 32 ]. Excellent safety and feasibility results of a simultaneous harvest and implantation were provided.…”

Outlook of Adipose-Derived Stem Cells: Challenges to Their Clinical Application in Horses

“…Adipose tissue is an abundant and convenient source of mesenchymal stem cells (MSCs) [ 1 ] that, together with those derived from bone marrow (BMSCs), possess a higher potential for application in cell-based therapy, where the primary purpose is to provoke and support regenerative processes in damaged tissues [ 2 , 3 ]. To date, in veterinary medicine, stem cells from adipose tissue have successfully been used mainly in horses and dogs for treating tendons and joint injuries, bone defects, musculoskeletal disorders, and even some kidney and ophthalmic diseases [ 3 , 4 , 5 , 6 ]. Obtaining material for the isolation of MSCs from adipose tissue ( Figure 1 ) is relatively non-invasive and non-traumatic; liposuction surgery is a cheaper and safer method than bone marrow aspiration [ 7 ].…”

“…2023, 10, x FOR PEER REVIEW 2 of 14 and support regenerative processes in damaged tissues [2,3]. To date, in veterinary medicine, stem cells from adipose tissue have successfully been used mainly in horses and dogs for treating tendons and joint injuries, bone defects, musculoskeletal disorders, and even some kidney and ophthalmic diseases [3][4][5][6]. Obtaining material for the isolation of MSCs from adipose tissue (Figure 1) is relatively non-invasive and non-traumatic; liposuction surgery is a cheaper and safer method than bone marrow aspiration [7].…”