Abstract 19177: Effect of Aging on Human Mesenchymal Stem Cell Therapy in Ischemic Cardiomyopathy Patients
Background: The role of patient age on the efficacy of mesenchymal stem cell (MSC) therapy in ischemic cardiomyopathy (ICM) is controversial, with some data suggesting a decline in responsiveness with age. We hypothesized that the therapeutic effect of culture expanded MSCs persists even in older subjects.
Methods: We divided ICM patients from the TAC-HFT and POSEIDON trials who received MSCs via transendocardial stem cell injection (TESI) into two age groups: <60 yrs vs. ≥ 60 yrs. Functional capacity measures: Six Minute Walking Distance (6MWD) and quality of life measures: Minnesota Living with Heart Failure Questionnaire (MLHFQ) score were compared at baseline, at 6 months and 1 year post-TESI. Cardiac imaging parameters including absolute scar size, ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and sphericity index (SI) were compared at baseline and 1-year post-TESI.
Results: Median age of the 49 patients was 63.2 years (range, 32.5-79.0 yrs) with 47% being <60 and 53% ≥ 60 yrs. At baseline, mean 6MWD was 418.3±14.9m (SEM) in <60 group and 372.1±18.2m in ≥60 group (p=0.06). 6MWD increased in response to cell therapy at 1-year post-TESI: 48.5±14.6m in <60 (p=0.001) and 35.9±18.3m (p=0.038) in ≥ 60 group (p=NS between-groups). While the ≥ 60 group (–7.04±3.54; p=0.022 within-group) exhibited a significant reduction in MLFHQ total score, with a trend toward a decrease in the ≥ 60 group (–11.22±5.24; p=0.058 within-group), no difference between groups was detected (p=NS). Statistically significant reductions in absolute scar size as a percent change from baseline at 1-year post-TESI were observed in both groups which did not differ by age; -33.4±5.4 in <60 (p<0.0001) and –32.9±5.3 in ≥60 group (p<0.0001; p=NS between-groups). Age had no significant effect on percent change of EF, EDV, ESV, or SI at 1-year post-TESI (between-group, p=NS).
Conclusion: MSC therapy via TESI in ICM patients significantly improves 6MWD and MLHFQ total score and reduces MI infarct size; importantly, older patients had identical effects as younger patients. Unlike the response to autologous whole bone marrow, therapeutic responses to culture expanded MSCs are not impaired in older patients.
Author Disclosures: S. Golpanian: None. J. El-Khorazaty: None. A. Mendizabal: None. D.L. Difede: None. W. Balkan: None. J.M. Hare: Employment; Modest; Vestion. Ownership Interest; Modest; Biscayne. Ownership Interest; Significant; Vestion Inc.
- © 2014 by American Heart Association, Inc.