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Updated: Oct 29, 2025
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Effect of cardiosphere-derived cells on segmental myocardial function after myocardial infarction: ALLSTAR randomised
Mohammad R Ostovaneh1,2, Raj R Makkar3, Bharath Ambale-Venkatesh1
1Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA.
Insights
Allogeneic cardiosphere-derived cells (CDCs) improved regional heart function after myocardial infarction (MI). This cell therapy showed benefits in segmental myocardial function, particularly in scar tissue areas, suggesting its potential for future clinical trials.
Area of Science:
- Cardiology
- Regenerative Medicine
- Biomedical Engineering
Background:
- Global left ventricular (LV) function measures often fail to detect improvements after myocardial infarction (MI) cell therapy.
- Myocardial segments are heterogeneously affected by MI, necessitating sensitive measures of regional function.
- Global indices may miss small, prognostically significant treatment effects on segmental myocardial function.
Purpose of the Study:
- To evaluate the efficacy of allogeneic cardiosphere-derived cells (CDCs) in enhancing regional myocardial function and contractility post-MI.
- To explore the impact of CDC therapy on segmental myocardial function, particularly in areas with scar tissue.
Main Methods:
- Exploratory analysis of a randomized clinical trial involving 142 patients with post-MI and LV ejection fraction (LVEF) <45%.
- Patients were randomized (2:1) to receive intracoronary infusion of allogeneic CDCs or placebo.
- Segmental myocardial circumferential strain (Ecc) changes were assessed using MRI from baseline to 6 months.
Main Results:
- A significantly greater improvement in segmental Ecc was observed in the CDC group (-0.5%) compared to placebo (0.2%) (p=0.05).
- The most substantial benefit in segmental Ecc improvement occurred in myocardial segments containing scar tissue.
- In scar tissue segments, CDC recipients showed an Ecc change of -0.7% versus 0.04% in the placebo group (p=0.04).
Conclusions:
- Allogeneic CDC administration improved segmental myocardial function in patients with post-MI LV dysfunction.
- Findings underscore the importance of using segmental myocardial function indices as key endpoints in future MI clinical trials.
- CDC therapy demonstrates potential for targeted improvement of regional cardiac function after myocardial infarction.
Background:
Most cell therapy trials failed to show an improvement in global left ventricular (LV) function measures after myocardial infarction (MI). Myocardial segments are heterogeneously impacted by MI. Global LV function indices are not able to detect the small treatment effects on segmental myocardial function which may have prognostic implications for cardiac events. We aimed to test the efficacy of allogeneic cardiosphere-derived cells (CDCs) for improving regional myocardial function and contractility.
Methods:
In this exploratory analysis of a randomised clinical trial, 142 patients with post-MI with LVEF <45% and 15% or greater LV scar size were randomised in 2:1 ratio to receive intracoronary infusion of allogenic CDCs or placebo, respectively. Change in segmental myocardial circumferential strain (Ecc) by MRI from baseline to 6 months was compared between CDCs and placebo groups.
Results:
In total, 124 patients completed the 6-month follow-up (mean (SD) age 54.3 (10.8) and 108 (87.1%) men). Segmental Ecc improvement was significantly greater in patients receiving CDC (-0.5% (4.0)) compared with placebo (0.2% (3.7), p=0.05). The greatest benefit for improvement in segmental Ecc was observed in segments containing scar tissue (change in segmental Ecc of -0.7% (3.5) in patients receiving CDC vs 0.04% (3.7) in the placebo group, p=0.04).
Conclusions:
In patients with post-MI LV dysfunction, CDC administration resulted in improved segmental myocardial function. Our findings highlight the importance of segmental myocardial function indices as an endpoint in future clinical trials of patients with post-MI.
Trial Registration Number:
NCT01458405.
