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Published on: January 7, 2019
The Use of Hematopoietic Stem Cells for Heart Failure: A Systematic Review
Jayant Seth1, Sohat Sharma1, Cameron J Leong1
1Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Insights
Hematopoietic stem cell therapy shows promise for treating ischemic heart damage. This therapy improved cardiac outcomes and reduced adverse events in heart failure patients.
Area of Science:
- Cardiology
- Regenerative Medicine
- Stem Cell Biology
Background:
- Ischemic heart damage remains a leading cause of mortality and morbidity worldwide.
- Current treatments for heart failure (HF) have limitations in addressing cardiac remodeling and function.
- Stem cell-based therapies offer a potential regenerative approach for myocardial repair.
Purpose of the Study:
- To review the therapeutic efficacy of hematopoietic stem cell (HSC) therapy for ischemic heart damage.
- To synthesize findings from randomized controlled trials (RCTs), observational, and cohort studies.
- To evaluate HSC effects on cardiac outcomes in adult heart failure patients.
Main Methods:
- Systematic literature search using PRISMA guidelines in MEDLINE and EMBASE.
- Screening of 592 studies for relevance to HSC therapy in ischemic heart damage.
- Inclusion of studies focusing on adult patients with heart failure, excluding pediatric and mesenchymal stem cell studies.
Main Results:
- Seven studies met inclusion criteria, evaluating HSC administration (intracoronary or myocardial infarct).
- Positive cardiac outcomes observed, including improved left-ventricular remodeling, post-myocardial infarction perfusion, and NYHA symptom class.
- Significant reduction in combined death, heart failure rehospitalization, and infarction in patients receiving bone marrow-derived HSCs.
Conclusions:
- Hematopoietic stem cell administration demonstrates therapeutic potential for improving cardiac outcomes in heart failure patients.
- HSC therapy may reduce adverse cardiovascular events, including mortality and rehospitalization.
- Future research should broaden inclusion criteria to encompass female patients and non-ischemic heart failure etiologies.
Abstract:
The purpose of this review is to summarize the current understanding of the therapeutic effect of stem cell-based therapies, including hematopoietic stem cells, for the treatment of ischemic heart damage. Following PRISMA guidelines, we conducted electronic searches in MEDLINE, and EMBASE. We screened 592 studies, and included RCTs, observational studies, and cohort studies that examined the effect of hematopoietic stem cell therapy in adult patients with heart failure. Studies that involved pediatric patients, mesenchymal stem cell therapy, and non-heart failure (HF) studies were excluded from our review. Out of the 592 studies, 7 studies met our inclusion criteria. Overall, administration of hematopoietic stem cells (via intracoronary or myocardial infarct) led to positive cardiac outcomes such as improvements in pathological left-ventricular remodeling, perfusion following acute myocardial infarction, and NYHA symptom class. Additionally, combined death, rehospitalization for heart failure, and infarction were significantly lower in patients treated with bone marrow-derived hematopoietic stem cells. Our review demonstrates that hematopoietic stem cell administration can lead to positive cardiac outcomes for HF patients. Future studies should aim to increase female representation and non-ischemic HF patients.
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