Related Experiment Video
Updated: May 11, 2026
Establishing a Swine Model of Post-myocardial Infarction Heart Failure for Stem Cell Treatment
Published on: May 25, 2020
Meta-analysis of stem cell therapy in chronic ischemic cardiomyopathy
Jagdesh Kandala1, Gaurav A Upadhyay, Evgeny Pokushalov
1Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Bone marrow stem cell therapy (BMSCT) improves heart function in chronic ischemic cardiomyopathy patients. Intramyocardial injection may be more effective than intracoronary infusion for enhancing left ventricular ejection fraction.
Area of Science:
- Cardiology
- Regenerative Medicine
- Stem Cell Therapy
Background:
- Chronic ischemic cardiomyopathy (CICMP) significantly impacts left ventricular (LV) function.
- Previous studies on bone marrow stem cell therapy (BMSCT) for CICMP have shown inconsistent outcomes.
- The optimal route of administration for BMSCT in CICMP remains unclear.
Purpose of the Study:
- To evaluate the efficacy of BMSCT in patients with CICMP.
- To determine the best route of administration for BMSCT in this patient population.
- To assess the impact of BMSCT on LV function and remodeling.
Main Methods:
- A meta-analysis of randomized controlled trials (RCTs) was conducted.
- Searched major databases (MEDLINE, Embase, CINAHL, Cochrane Library) through April 2012.
- Included 10 RCTs with 519 patients diagnosed with CICMP and systolic dysfunction.
Main Results:
- BMSCT significantly improved left ventricular ejection fraction (LVEF) by 4.48% at 6 months (p=0.0001).
- Intramyocardial injection demonstrated a greater LVEF improvement (5.13%) compared to intracoronary infusion (2.32%).
- BMSCT led to significant reductions in LV end-systolic volume (-20.64 ml) and LV end-diastolic volume (-16.71 ml).
Conclusions:
- BMSCT shows potential for improving LVEF and promoting favorable cardiac remodeling in CICMP patients.
- Intramyocardial injection may be a superior administration route compared to intracoronary infusion, based on current data.
- Further research is warranted to confirm these findings and optimize BMSCT protocols.
Abstract:
Studies investigating bone marrow stem cell therapy (BMSCT) in patients with chronic ischemic cardiomyopathy have yielded mixed results. A meta-analysis of randomized controlled trials of BMSCT in patients with chronic ischemic cardiomyopathy was undertaken to assess its efficacy and the best route of administration. The MEDLINE, Embase, Cumulative Index to Nursing & Allied Health Literature, and Cochrane Library databases were searched through April 2012 for randomized controlled trials that investigated the impact of BMSCT and its route of administration on left ventricular (LV) function in patients with chronic ischemic cardiomyopathy and systolic dysfunction. Of the 226 reports identified, 10 randomized controlled trials including 519 patients (average LV ejection fraction [LVEF] at baseline 32 ± 7%) were included in the analysis. On the basis of a random-effects model, BMSCT improved the LVEF at 6 months by 4.48% (95% confidence interval [CI] 2.43% to 6.53%, p = 0.0001). A greater improvement in the LVEF was seen with intramyocardial injection compared with intracoronary infusion (5.13% [95% CI 3.17% to 7.10%], p <0.00001, vs 2.32% [95% CI -2.06% to 6.70%], p = 0.30). Overall, there were reductions in LV end-systolic volume of -20.64 ml (95% CI -33.21 to -8.07, p = 0.001) and LV end-diastolic volume of -16.71 ml (95% CI -31.36 to -2.06, p = 0.03). In conclusion, stem cell therapy may improve LVEF and favorably remodel the heart in patients with chronic ischemic cardiomyopathy. On the basis of current limited data, intramyocardial injection may be superior to intracoronary infusion in patients with LV systolic dysfunction.
