Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis

Background: While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. M...

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Main Authors: Salman Muslem, Mariam AlTurani, Muhammad Bilal Maqsood, Maryam Al Qaseer
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Diseases
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Online Access:https://www.mdpi.com/2079-9721/13/5/136
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author Salman Muslem
Mariam AlTurani
Muhammad Bilal Maqsood
Maryam Al Qaseer
author_facet Salman Muslem
Mariam AlTurani
Muhammad Bilal Maqsood
Maryam Al Qaseer
author_sort Salman Muslem
collection DOAJ
description Background: While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. MSC therapy has shown promise by targeting left ventricular pressure and improving wall thickness, contributing to reductions in HF-related morbidity and mortality rates. This systematic review and meta-analysis bridges a gap in current research through a focused examination of the most recent clinical trials to cohesively assess MSC therapy in HFrEF patients. Methods: We conducted a systematic review and meta-analysis of clinical trials published from 2018 onwards, which were obtained from multiple databases such as PUBMED, Scopus, EBSCO Medline, EBSCO CINAHL Science Direct, and the Cochrane Library. This review investigates the efficacy and safety outcomes of MSC therapy in patients above 18 years of age with a known diagnosis of heart failure with a reduced ejection fraction (HFrEF). The primary outcome was the change in the left ventricular ejection fraction (LVEF). Secondary outcomes encompassed several efficacy outcomes, such as Global Circumferential strain (GCS), the 6-Minute Walk Test (6MWT), Quality of Life (QoL), and major adverse cardiac events (MACE). A PRISMA flow diagram was constructed to illustrate the identification, screening, eligibility, and inclusion of studies at each stage of the review process. Results: A total of 330 studies were initially identified, but only 12 met the inclusion criteria. MSC therapy resulted in a small, non-significant improvement in LVEF (Hedges’ g = 0.096, <i>p</i> = 0.18) with low heterogeneity (I² = 0.5%). Only QoL showed significant improvement (Hedges’ g = −0.518, <i>p</i> = 0.01). No significant changes in other efficacy outcomes were observed. The therapy was not associated with an increased risk of MACE. Conclusion: While MSC therapy was safe and improved QoL for HFrEF patients, it did not significantly improve LVEF or other efficacy outcomes. Further large-scale, standardized trials are required to better understand the potential role of MSCs in heart failure (HF) therapy.
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spelling doaj-art-c93d04bedea744c2a931a9fbb65005552025-08-20T03:14:46ZengMDPI AGDiseases2079-97212025-04-0113513610.3390/diseases13050136Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-AnalysisSalman Muslem0Mariam AlTurani1Muhammad Bilal Maqsood2Maryam Al Qaseer3Salmaniya Medical Complex, Manama P.O. Box 11190, BahrainRoyal College of Surgeons, Ireland-Medical University of Bahrain, Manama P.O. Box 15503, BahrainClinical Excellence, Eastern Health Cluster, Dammam 32253, Saudi ArabiaDepartment of Cardiology, King Fahad Specialist Hospital, Eastern Health Cluster, Dammam 32253, Saudi ArabiaBackground: While heart failure with reduced ejection fraction (HFrEF) remains a major global health burden, mesenchymal stem cell (MSC) therapy has emerged as a promising intervention designed to improve cardiac function and reduce morbidity among patients unresponsive to conventional treatments. MSC therapy has shown promise by targeting left ventricular pressure and improving wall thickness, contributing to reductions in HF-related morbidity and mortality rates. This systematic review and meta-analysis bridges a gap in current research through a focused examination of the most recent clinical trials to cohesively assess MSC therapy in HFrEF patients. Methods: We conducted a systematic review and meta-analysis of clinical trials published from 2018 onwards, which were obtained from multiple databases such as PUBMED, Scopus, EBSCO Medline, EBSCO CINAHL Science Direct, and the Cochrane Library. This review investigates the efficacy and safety outcomes of MSC therapy in patients above 18 years of age with a known diagnosis of heart failure with a reduced ejection fraction (HFrEF). The primary outcome was the change in the left ventricular ejection fraction (LVEF). Secondary outcomes encompassed several efficacy outcomes, such as Global Circumferential strain (GCS), the 6-Minute Walk Test (6MWT), Quality of Life (QoL), and major adverse cardiac events (MACE). A PRISMA flow diagram was constructed to illustrate the identification, screening, eligibility, and inclusion of studies at each stage of the review process. Results: A total of 330 studies were initially identified, but only 12 met the inclusion criteria. MSC therapy resulted in a small, non-significant improvement in LVEF (Hedges’ g = 0.096, <i>p</i> = 0.18) with low heterogeneity (I² = 0.5%). Only QoL showed significant improvement (Hedges’ g = −0.518, <i>p</i> = 0.01). No significant changes in other efficacy outcomes were observed. The therapy was not associated with an increased risk of MACE. Conclusion: While MSC therapy was safe and improved QoL for HFrEF patients, it did not significantly improve LVEF or other efficacy outcomes. Further large-scale, standardized trials are required to better understand the potential role of MSCs in heart failure (HF) therapy.https://www.mdpi.com/2079-9721/13/5/136mesenchymal stem cellsheart failureejection fractionefficacy outcomesquality of life
spellingShingle Salman Muslem
Mariam AlTurani
Muhammad Bilal Maqsood
Maryam Al Qaseer
Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
Diseases
mesenchymal stem cells
heart failure
ejection fraction
efficacy outcomes
quality of life
title Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
title_full Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
title_fullStr Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
title_full_unstemmed Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
title_short Cardiac Repair and Clinical Outcomes of Stem Cell Therapy in Heart Failure: A Systematic Review and Meta-Analysis
title_sort cardiac repair and clinical outcomes of stem cell therapy in heart failure a systematic review and meta analysis
topic mesenchymal stem cells
heart failure
ejection fraction
efficacy outcomes
quality of life
url https://www.mdpi.com/2079-9721/13/5/136
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AT muhammadbilalmaqsood cardiacrepairandclinicaloutcomesofstemcelltherapyinheartfailureasystematicreviewandmetaanalysis
AT maryamalqaseer cardiacrepairandclinicaloutcomesofstemcelltherapyinheartfailureasystematicreviewandmetaanalysis