Cell Therapy for Cardiovascular Disorders - Applications of Biotechnology in Cardiovascular Therapeutics - page 193

Currently several clinical trials are in progress to test the usefulness and safety
of various types of cells in CHF. These are listed at the NIH web site ( http://www.
clinicaltrials.gov ) and a selection is shown here:

• ALCADIA: Intramyocardial injection of CSCs

• CADUCEUS: Intracoronary injection of cardiosphere-derived stem cells

• Cardio 133: Intramyocardial injection of CD133+ stem cells

• Combined CABG and stem cell therapy for heart failure using intramyocardial

BMMSCs
FOCUS Study: Intramyocardial injection of MNCs •

• IMPACT-CABG Trial: Intramyocardial injection of CD133+ stem cells

• REVITALIZE: Intracoronary injection of MNCs

• SCIPIO: Intracoronary injection of CSCs

• Surgical treatment with intramyocardial injection of CD34+ autologous stem cells

• TAC-HFT: Transendocardial injection of hMSCs and hBMCs

Myoblasts for Treatment of Congestive Heart Failure

Skeletal myoblast transplantation in a postmyocardial infarction scar experimen-
tally improves left ventricular ejection fraction. Short-term follow-up studies have
suggested that a similar benefit could clinically occur despite an increased risk of
cardiac arrhythmias. The long-term follow-up of the first worldwide cohort of
grafted patients operated on with use of autologous skeletal muscle myoblast trans-
plant and bypass surgery in 2000-2001 (Hagege et al. 2006 ). In this cohort of
severe heart failure patients, both clinical status and ejection fraction stably improve
over time with a strikingly low incidence of hospitalizations for heart failure and
the arrhythmic risk can be controlled by medical therapy and/or on-request auto-
matic cardiac defibrillator implantation.
Combined transplantation of skeletal myoblasts and angiopoietic progenitor
cells results in ventricular function improvement, reduction of scar size, and myo-
cardial apoptosis, and increased neoangiogenesis in chronic ischemia induced
experimentally in rats (Bonaros et al. 2006 ). Clinical studies are warranted to prove
this new therapeutic concept. Grafting of skeletal myoblast sheets attenuated car-
diac remodeling and improved cardiac performance in dogs (Hata et al. 2006 ).
Feasibility and effectiveness of this method in a large animal model suggests that
it is an innovative and promising strategy for treating patients with end-stage
dilated cardiomyopathy.

Injection of Adult Stem Cells for Congestive Heart Failure

Results of first prospective randomized trial of injecting adult stem cells into
the damaged heart tissue of people with severe CHF, presented by the University
of Pittsburgh's McGowan Institute for Regenerative Medicine in 2004, showed