Regenerative Medicine Clinic: Transforming Cardiac Therapy

Eduardo Marbán, MD, PhD, director of the Smidt Heart Institute, changed the path of cardiovascular science when he pioneered the use of cardiac stem cells to reduce the damage caused by heart attack. Now, physicians and researchers at the Smidt Heart Institute's Regenerative Medicine Clinic are poised to transform cardiac care again with a slate of new clinical trials led by Marbán and Timothy Henry, MD, director of Cardiology and the Lee and Harold Kapelovitz Chair in Research Cardiology.

Under Marbán's direction, Cedars-Sinai scientists at the Board of Governors Heart Stem Cell Center were the first in the world to complete a revolutionary clinical trial using patients' own heart stem cells to grow and repair cardiac tissue. As detailed in the Journal of the American College of Cardiology, one year after treatment, heart attack scar size was reduced from 23.9 percent to 12.9 percent of the heart in patients treated with stem cells — an average drop of about 46 percent.

The two latest studies at Cedars-Sinai focus on donor-derived heart stem cells.

Both of these studies use allogeneic (off-the-shelf) cardiac stem cells, eliminating the need to harvest tissue from any given patient. The first study, ALLSTAR, is an ongoing trial for patients experiencing heart attack and weakened hearts. The second trial, DYNAMIC, includes patients with advanced heart failure. As these patients' hearts progressively weaken, their only recourse — other than experimental therapies — might be a transplant or mechanical circulatory support.

"We intend to keep pushing the frontiers of investigational stem cell therapy and redefining what it means to receive the dreaded diagnosis of heart failure," Marbán said. "Perhaps this need not be a grim disease with a prognosis worse than that of many malignant tumors."

The Smidt Heart Institute's Regenerative Medicine Clinic offers consultative services for patients with a range of cardiovascular disorders and matches them with clinical trials when appropriate.

"The future is happening now at the Smidt Heart Institute," Henry said. "We want to provide patients with next-generation treatments whenever possible."