RECRUITING

Human Embryonic Stem Cell-Derived Cardiomyocyte Therapy for Chronic Ischemic Left Ventricular Dysfunction

Conditions

Chronic Ischemic Left Ventricular Dysfunction

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This clinical study will utilize a new cell therapy approach (Human embryonic stem cells derived cardiomyocytes or hESC-CMs) to improve survival and cardiac function in patients with chronic left ventricular dysfunction secondary to MI (Myocardial Infarction).

Official Title

A Phase I, Randomized Pilot Study of Human Embryonic Stem Cell-Derived Cardiomyocytes (hESC-CMs) in PaTients with ChrOnic Ischemic Left VentRicular Dysfunction Secondary to Myocardial Infarction (HECTOR)

Quick Facts

Study Start:2022-03-22

Study Completion:2025-10

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT05068674

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:21 Years to 80 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Be ≥ 21 and \< 80 years of age. * Provide written informed consent. * Have a diagnosis of chronic ischemic left ventricular dysfunction secondary to MI as defined by previous myocardial infarction documented by an imaging study demonstrating coronary artery disease with corresponding areas of akinesis, dyskinesis, or severe hypokinesis. * Be a candidate for cardiac catheterization within 5 to 10 weeks of screening. * Have been treated with appropriate maximal medical therapy for heart failure or postinfarction left ventricular dysfunction. For beta-blockade, the patient must have been on a stable dose of a clinically appropriate beta-blocker for 3 months. For angiotensinconverting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) or angiotensin receptor neprilysin inhibitors (ARNIs) or have appropriate medical indication precluding use of one or both of these agents, the patient must have been on a stable dose of a clinically appropriate agent for 1 month or within no more than doubling the dose of any of ARB, ACE inhibitors, and ARNIs over the last 3 months. * Left ventricular ejection fraction below 40%. * Class II/III NYHA symptoms of heart failure within the 6 months prior to baseline testing. * Hospitalization in the past 6 months or NT pro-BNP \> 1200 pg/mL, or \>1600 pg/mL if atrial fibrillation was present. * Automated implantable cardioverter-defibrillator (AICD) in place.	* Have a baseline glomerular filtration rate \< 35 ml/min/1.73 m2 * Have a known, serious radiographic contrast allergy. * Have a prosthetic aortic valve or heart constrictive device. * Have a documented presence of aortic stenosis (aortic stenosis graded as 1.5 cm2 or less). * Have a documented presence of moderate to severe aortic insufficiency (echocardiographic assessment of aortic insufficiency graded as ≥+2). * Have evidence of a life-threatening arrhythmia in the absence of a defibrillator (nonsustained ventricular tachycardia ≥ 20 consecutive beats or complete second- or third-degree heart block in the absence of a functioning pacemaker) or QTc interval \> 550 ms on screening ECG. * AICD firing in the past 60 days prior to enrollment. * Be eligible for or require coronary artery revascularization. * Have a hematologic abnormality as evidenced by hematocrit \< 25%, white blood cell \< 2,500/µl, or platelet values \< 100,000/µl without another explanation. * Have liver dysfunction, as evidenced by enzymes (AST and ALT) greater than three times the ULN. * Have a coagulopathy (INR \> 1.3) not due to a reversible cause (i.e., Coumadin). Patients on Coumadin will be withdrawn 5 days before the procedure and confirmed to have an INR \< 1.3. Patients who cannot be withdrawn from Coumadin will be excluded from enrollment. * Have known allergies to penicillin or streptomycin. * Be an organ transplant recipient. * Have a history of organ or cell transplant rejection. * Have a clinical history of malignancy within 5 years (i.e., patients with prior malignancy must be disease-free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma. * Have a non-cardiac condition that limits lifespan to \< 1 year. * Be on chronic therapy with immunosuppressant medication, such as corticosteroids or TNFα antagonists. * Be serum-positive for HIV, hepatitis BsAg, or viremic hepatitis C. * Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial. * Be a female patient who is pregnant, nursing, or have child-bearing potential but is not using effective birth control. * Tested positive for SARS-CoV-2 within the last 30 days

Inclusion Criteria

Exclusion Criteria

* Be ≥ 21 and \< 80 years of age.
* Provide written informed consent.
* Have a diagnosis of chronic ischemic left ventricular dysfunction secondary to MI as defined by previous myocardial infarction documented by an imaging study demonstrating coronary artery disease with corresponding areas of akinesis, dyskinesis, or severe hypokinesis.
* Be a candidate for cardiac catheterization within 5 to 10 weeks of screening.
* Have been treated with appropriate maximal medical therapy for heart failure or postinfarction left ventricular dysfunction. For beta-blockade, the patient must have been on a stable dose of a clinically appropriate beta-blocker for 3 months. For angiotensinconverting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) or angiotensin receptor neprilysin inhibitors (ARNIs) or have appropriate medical indication precluding use of one or both of these agents, the patient must have been on a stable dose of a clinically appropriate agent for 1 month or within no more than doubling the dose of any of ARB, ACE inhibitors, and ARNIs over the last 3 months.
* Left ventricular ejection fraction below 40%.
* Class II/III NYHA symptoms of heart failure within the 6 months prior to baseline testing.
* Hospitalization in the past 6 months or NT pro-BNP \> 1200 pg/mL, or \>1600 pg/mL if atrial fibrillation was present.
* Automated implantable cardioverter-defibrillator (AICD) in place.

* Have a baseline glomerular filtration rate \< 35 ml/min/1.73 m2
* Have a known, serious radiographic contrast allergy.
* Have a prosthetic aortic valve or heart constrictive device.
* Have a documented presence of aortic stenosis (aortic stenosis graded as 1.5 cm2 or less).
* Have a documented presence of moderate to severe aortic insufficiency (echocardiographic assessment of aortic insufficiency graded as ≥+2).
* Have evidence of a life-threatening arrhythmia in the absence of a defibrillator (nonsustained ventricular tachycardia ≥ 20 consecutive beats or complete second- or third-degree heart block in the absence of a functioning pacemaker) or QTc interval \> 550 ms on screening ECG.
* AICD firing in the past 60 days prior to enrollment.
* Be eligible for or require coronary artery revascularization.
* Have a hematologic abnormality as evidenced by hematocrit \< 25%, white blood cell \< 2,500/µl, or platelet values \< 100,000/µl without another explanation.
* Have liver dysfunction, as evidenced by enzymes (AST and ALT) greater than three times the ULN.
* Have a coagulopathy (INR \> 1.3) not due to a reversible cause (i.e., Coumadin). Patients on Coumadin will be withdrawn 5 days before the procedure and confirmed to have an INR \< 1.3. Patients who cannot be withdrawn from Coumadin will be excluded from enrollment.
* Have known allergies to penicillin or streptomycin.
* Be an organ transplant recipient.
* Have a history of organ or cell transplant rejection.
* Have a clinical history of malignancy within 5 years (i.e., patients with prior malignancy must be disease-free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma.
* Have a non-cardiac condition that limits lifespan to \< 1 year.
* Be on chronic therapy with immunosuppressant medication, such as corticosteroids or TNFα antagonists.
* Be serum-positive for HIV, hepatitis BsAg, or viremic hepatitis C.
* Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial.
* Be a female patient who is pregnant, nursing, or have child-bearing potential but is not using effective birth control.
* Tested positive for SARS-CoV-2 within the last 30 days

Contacts and Locations

Study Contact

Joseph C. Wu, MD, PhD

CONTACT

(650) 736-2246

joewu@stanford.edu

Evgenios Neofytou, MD

CONTACT

(650) 736-2246

neofytou@stanford.edu

Study Locations (Sites)

Stanford Hospital and Clinics

Palo Alto, California, 94305

United States

Collaborators and Investigators

Sponsor: Joseph C. Wu

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2022-03-22

Study Completion Date2025-10

Study Record Updates

Study Start Date2022-03-22

Study Completion Date2025-10

Terms related to this study

Additional Relevant MeSH Terms

Chronic Ischemic Left Ventricular Dysfunction