Review Article

Cellular Therapeutics for Heart Failure: Focus on Mesenchymal Stem Cells

Table 1

Clinical trials investigating mesenchymal stem cells in heart failure.

Study nameTrialPhaseResultsTrial identifierCitation

Comparison of allogeneic vs autologous bone marrow-derived mesenchymal stem cells delivered by transendocardial injection in patients with ischemic cardiomyopathy: the POSEIDON randomized trial
(POSEIDON)
To test whether allogeneic MSCs are as safe and effective as autologous
MSCs in patients with left ventricular (LV) dysfunction due to ICM
Phase 1/2 randomizedPatients with ICM that received transendocardial injection of allogeneic and autologous MSCs demonstrated favorable outcomes on patient functional capacity, quality of life, and ventricular remodeling without adverse effectsNCT01087996[32]

Cardiopoietic stem cell therapy in heart failure: the C-CURE (cardiopoietic stem cell therapy in heart failure) multicenter randomized trial with lineage-specified biologics
(C-CURE)
To evaluate the feasibility and safety of autologous bone marrow-derived and cardiogenically oriented mesenchymal stem cell therapy and to probe for signs of efficacy in patients with chronic heart failureProspective, multicenter, randomized trialCardiopoietic stem cell therapy was found feasible and safe with signs of benefit in chronic heart failure, meriting definitive clinical evaluationNCT00810238[67]

Transendocardial mesenchymal stem cells and mononuclear bone marrow cells for ischemic cardiomyopathy: the TAC-HFT randomized trial
(TAC-HFT)
To demonstrate the safety of transendocardial stem cell injection with autologous mesenchymal stem cells (MSCs) and bone marrow mononuclear cells in patients with ischemic cardiomyopathyPhase 1 and 2 randomized, blinded, placebo-controlledstudyTransendocardial stem cell injection with MSCs or bone marrow mononuclear cells appeared to be safe for patients with chronic ischemic cardiomyopathy and LV dysfunctionNCT00768066[73]

Rationale and design of the first randomized, double-blind, placebo-controlled trial of intramyocardial injection of autologous bone-marrow derived mesenchymal stromal cells in chronic ischemic heart failure (MSC-HF Trial)
(MSC-HF)
To investigate the role of MSCs in patients with chronic ischemia utilizing intramyocardial injections in an ischemic viable region of the myocardium using the electromechanical NOGA-XP systemPhase 2, single-center, double-blind, randomized, placebo-controlledtrialIntramyocardial injection of bone marrow-derived MSCs decreased LVEV, improved LV EF, increased stroke volume, and increased myocardial mass significantly compared to placeboNCT00644410[76]

A randomized study of transendocardial injection of autologous bone marrow mononuclear cells and cell function analysis in ischemic heart failure (FOCUS-HF)
(FOCUS-HF)
To evaluate the safety and efficacy of the transendocardial delivery of autologous bone marrow mononuclear cells in patients with chronic HFPhase 1, single-blind trialAutologous bone marrow mononuclear cell therapy is safe and improves symptoms, quality of life, and possibly perfusion in patients with chronic HFNCT00203203[69]

RIMECARDTo assess the safety and efficacy of umbilical cord-derived MSCs in compensated dilated CMPhase 1/2CompletedNCT01739777

TEVA CEP-41750
(DREAM-HF)
To evaluate efficacy and safety of allogeneic mesenchymal precursor cells (CEP-41750) for the treatment of chronic HFPhase 3OngoingNCT02032004

Combination of mesenchymal and C-kit+ cardiac stem cells as regenerative therapy for heart failure
(CONCERT-HF)
To evaluate the feasibility, safety, and effect of MSCs CSCs, and combination in heart failure of ischemic etiology, administered by transendocardial injection in ischemic cardiomyopathyPhase 2 randomized, placebo-controlledclinical trialOngoingNCT02501811

Intravenous administration of allogeneic bone marrow-derived multipotent mesenchymal stromal cells (MSCs) in patients with recent onset anthracycline-associated cardiomyopathyTo learn if adding mesenchymal stem cells (MSCs) to standard-of-care drugs can help control heart failure that may have been caused by anthracyclinesPhase 1OngoingNCT02408432

Intravenous allogeneic mesenchymal stem cells for nonischemic cardiomyopathy: safety and efficacy results of a phase II-A randomized trialTo assess the safety and preliminary efficacy of intravenously administered ischemia-tolerant MSCs (itMSCs) in patients with nonischemic cardiomyopathyPhase 2 single-blind, placebo-controlled, crossover, randomizedIn patients with nonischemic cardiomyopathy, ischemia-tolerant MSC therapy was safe, caused immunomodulatory effects, and was associated with improvements in health status and functional capacityNCT02467387[72]

A randomized clinical trial of adipose-derived stem & regenerative cells in the treatment of patients with non revascularizable ischemic myocardium – the PRECISE trial
(PRECISE)
To establish safety and feasibility of utilizing adipose derived stem & regenerative cells (ADRCs) in patients who have areas of myocardium that are not revascularizable and have demonstrated reversible ischemiaPhase 1, randomized, double-blind trialIsolation and transendocardial injection of autologous ADRCs in no-option patients were safe and feasibleNCT00426868

Allogeneic adipose tissue-derived stromal/stem cell therapy in patients with ischemic heart disease and heart failure - a safety studyTo perform a small clinical safety trial in heart failure patients with allogeneic adipose tissue-derived mesenchymal stem cellsPhase 1OngoingNCT02387723
2015-001560-19

Stem cell therapy in ischemic non-treatable cardiac disease - SCIENCE A European Multi-Centre Trial
(SCIENCE)
To investigate the efficacy of direct intramyocardial injection allogeneic adipose-derived stem cells in patients with reduced left ventricular ejection fraction (EF) (≤45%) and heart failurePhase 2, double-blind, placebo-controlledtrialOngoingNCT02673164
2015-002929-19

Efficacy and safety of bone marrow-derived mesenchymal cardiopoietic cells (C3BS-CQR-1) for the treatment of chronic advanced ischemic heart failure
(CHART-1)
To evaluate the safety and efficacy of C3BS-CQR-1 by comparing the overall response to standard of care and C3BS-CQR-1 relative to standard of care and a sham procedurePhase 3, randomized, double-blind trialOngoingNCT01768702