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Updated: Jun 14, 2026
Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment
Published on: May 25, 2020
How to measure the effects of the intracoronary stem cell therapy?
Insights
Stem cell therapy may moderately improve left ventricular ejection fraction (LVEF) in heart attack patients. However, long-term studies suggest focusing on diastolic function and tissue-Doppler imaging may better assess treatment effects.
Area of Science:
- Cardiology
- Regenerative Medicine
- Biomedical Engineering
Background:
- Clinical studies indicate stem cell therapy can moderately increase left ventricular ejection fraction (LVEF) 4-6 months post-treatment.
- Traditional endpoints like LVEF via angiography or MRI may not fully capture the benefits of bone marrow cell (BMC) therapy.
- The BOOST trial showed no sustained improvement in LV systolic function after 5 years, but noted beneficial effects on diastolic function.
Discussion:
- Tissue-Doppler imaging revealed improved regional LV systolic function after implanting specific bone marrow-derived cells (CD133+ and CD133-CD34+) in patients with anterior myocardial infarction (MI) and reduced LVEF.
- The clinical significance of these functional improvements requires further investigation.
- Diastolic function assessment and tissue-Doppler imaging show promise as valuable parameters for future stem cell trials.
Key Insights:
- Stem cell therapy shows potential for moderate LVEF improvement post-MI.
- Long-term effects on systolic function are not consistently sustained.
- Diastolic function and advanced imaging techniques may offer more sensitive measures of therapeutic efficacy.
Outlook:
- Further research is needed to establish the clinical significance of observed functional improvements.
- Tissue-Doppler imaging and diastolic function assessment should be prioritized in future stem cell trials for myocardial infarction.
- Optimizing cell selection and delivery methods may enhance therapeutic outcomes.
Abstract:
The results of clinical studies showed that there is a moderate increase in left ventricular (LV) ejection fraction (EF) at 4-6 months after stem cell therapy. So far, the endpoint of such trials was the change of LVEF and volumes measured by LV angiography or MRI; however, these parameters might not be optimal to assess the effects of BMC therapy. BOOST trial was one of the first studies addressing the effect of bone marrow cell transfer in patients with acute ST-elevation myocardial infarction. The results of 5-year follow-up were reported, showed no sustained effect on the LV systolic function in the whole group, but some beneficial effects on diastolic function were found. Other study showed using tissue-Doppler that after implantation of selected CD133+ and CD133-CD34+ bone marrow-derived cells in patients with history of anterior MI and severely reduced LVEF the indices of regional LV systolic function improved. Clinical significance of these findings remains to be established; however, the assessment of diastolic function and tissue-Doppler imaging might be valuable parameters in stem cell-based trials.
