Bibliographic record
Abstract
This article refers to 'Bone marrow-derived mesenchymal stromal cell treatment in patients with ischaemic heart failure: final 4-year follow-up of the MSC-HF trial' by A.B. Mathiasen et al., published in this issue on pages 884-892.In this issue of the Journal, Mathiasen and colleagues report the final results of MSC-HF, a randomized, double-blind, placebo-controlled, Phase II study that evaluated transendocardial injection of autologous bone marrow (BM)-derived mesenchymal stromal cells (MSCs) in 60 patients with ischaemic heart failure (HF). 1 At 12 months after MSC administration, there was a significant improvement in the primary endpoint [change in left ventricular end-systolic volume (LVESV)] relative to placebo (-17 mL; P < 0.0002).This was associated with an improvement, relative to placebo, in left ventricular ejection fraction (LVEF) (+6.2 units; P < 0.0001), myocardial mass (+9.8 g; P = 0.009), and quality of life.Interestingly, over the 4-year follow-up the incidence of angina was reduced in the MSC group.The MSC-HF trial is one of the best-designed studies of cardiovascular cell therapy performed to date.Overall, the 12-month results confirm and extend those reported previously at 6 months.2 The present paper 1 is important because it indicates that, in patients with ischaemic HF, a single injection of autologous MSCs produces an improvement in left ventricular function and structure that is sustained for at least 12 months, and may be associated with clinical benefits for up to 4 years.The increase in LVEF (+6.2 units relative to control) was comparable to that effected by commonly used interventions such as early reperfusion in ST-elevation myocardial infarction or cardiac resynchronization therapy.Of note, MSC-HF utilized autologous BM-MSCs.Most cardiovascular trials nowadays use allogeneic MSCs, which may be more effective because they avoid the potential confounding effects of comorbidities. 3 Given that transplanted cells do not differentiate into cardiomyocytes and do not survive more than a few weeks, 4 it is remarkable that the salubrious effects of a single injection of BM-MSCs persisted for at least 12 months.Such a duration of benefit after one dose has not been observed with any medical therapy for HF.How a transient exposure to BM-MSC-secreted factors leads to long-term improvement is anThe opinions expressed in this article are not necessarily those of the Editors of the European Journal of Heart Failure or of the European Society of Cardiology.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.007 | 0.008 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.008 | 0.017 |
| Insufficient payload (model declined to judge) | 0.069 | 0.033 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".