title: Effect of aging on human mesenchymal stem cell therapy in ischemic cardiomyopathy patients.
abstract: BACKGROUND
  The role of patient age in the efficacy of mesenchymal stem cell (MSC) therapy in ischemic cardiomyopathy (ICM) is controversial.
  
  
  OBJECTIVE
  This study sought to determine whether the therapeutic effect of culture-expanded MSCs persists, even in older subjects.
  
  
  METHODS
  Patients with ICM who received MSCs via transendocardial stem cell injection (TESI) as part of the TAC-HFT (Transendocardial Autologous Cells in Ischemic Heart Failure) (n = 19) and POSEIDON (Percutaneous Stem Cell Injection Delivery Effects on Neomyogenesis) (n = 30) clinical trials were divided into 2 age groups: younger than 60 and 60 years of age and older. Functional capacity was measured by 6-min walk distance (6MWD) and quality of life using the Minnesota Living With Heart Failure Questionnaire (MLHFQ) score, measured at baseline, 6 months, and 1 year post-TESI. Various cardiac imaging parameters, including absolute scar size, were compared at baseline and 1 year post-TESI.
  
  
  RESULTS
  The mean 6MWD was similar at baseline and increased at 1 year post-TESI in both groups: 48.5 ± 14.6 m (p = 0.001) for the younger and 35.9 ± 18.3 m (p = 0.038) for the older participants (p = NS between groups). The older group exhibited a significant reduction in MLHFQ score (-7.04 ± 3.54; p = 0.022), whereas the younger than 60 age group had a borderline significant reduction (-11.22 ± 5.24; p = 0.058) from baseline (p = NS between groups). Although there were significant reductions in absolute scar size from baseline to 1 year post-TESI, the effect did not differ by age.
  
  
  CONCLUSIONS
  MSC therapy with TESI in ICM patients improves 6MWD and MLHFQ score and reduces myocardial infarction size. Importantly, older individuals did not have an impaired response to MSC therapy.
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Samuel
authors.initials: S
authors.lastname: Golpanian
authors.affiliation: EMMES Corporation, Rockville, Maryland.
authors.forename: Jill
authors.initials: J
authors.lastname: El-Khorazaty
authors.affiliation: EMMES Corporation, Rockville, Maryland.
authors.forename: Adam
authors.initials: A
authors.lastname: Mendizabal
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Darcy L
authors.initials: DL
authors.lastname: DiFede
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Viky Y
authors.initials: VY
authors.lastname: Suncion
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Karantalis
authors.affiliation: Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Joel E
authors.initials: JE
authors.lastname: Fishman
authors.affiliation: Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Eduard
authors.initials: E
authors.lastname: Ghersin
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Wayne
authors.initials: W
authors.lastname: Balkan
authors.affiliation: Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: jhare@med.miami.edu.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Hare
mesh_terms: D000328:Adult; D000375:Aging; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: heart failure; infarct size; ischemic heart disease