AzTrials
AzTrials

Ischemic Heart DiseasePhase 2CATONCT06145035

Single or Repeated Intravenous Administration of umbiliCAl Cord Mesenchymal sTrOmal Cells in Ischemic Cardiomyopathy

A Phase 2 study testing umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in people with Ischemic Heart Disease, run by Roberto Bolli at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a Phase IIA, randomized, double blind, placebo controlled, multicenter study designed to assess the safety, feasibility, and efficacy of umbilical cord derived mesenchymal stromal cells (UC MSCs, stem cells), administered intravenously (IV) as a single dose or repeated doses, in patients with ischemic… Read more about this study

Who is it for?
Ages 21 to 85 years
Conditions the study is for
Ischemic Heart Disease
What is being tested?
umbilical cord-derived mesenchymal stromal cells (UC-MSCs)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
3 sitesUnited States
Study dates
4 Mar 2024to 1 Sep 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Be ≥ 21 and ≤ 85 years of age.
  • Have documented CAD (> 70% lesion in at least 1 epicardial vessel) with evidence of myocardial injury, LV dysfunction, and clinical evidence of HF.
  • Have a "detectable" area of myocardial injury defined as ≥ 5% LV involvement (infarct volume) and any subendocardial involvement by MRI.
  • Have an EF ≤ 40% by MRI.
  • Be receiving guideline driven medical therapy for HF (beta blockers, diuretics, ACE inhibitors or ARBs, or ARNIs, aldosterone antagonists, hydralazine isosorbide, sodium-glucose transporter 2 inhibitors) ) at stable, maximally tolerated doses for ≥ 1 month prior to consent. "Stable" is defined as stable dose with no changes for 30 days after last dose adjustment. For beta blockade "stable" is defined as no greater than a 50% reduction in dose or no more than a 100% increase in dose.
  • Have NYHA class I, II or III symptoms of HF (see Appendix A)
  • If a female of childbearing potential, be willing to use one form of birth control for the duration of the study and undergo a serum pregnancy test at baseline and within 36 hours prior to infusion

Who cannot join

  • Indication for standard of care surgery (including valve surgery, placement of left ventricular assist device, or imminent heart transplantation), coronary artery bypass grafting (CABG) procedure, and/or percutaneous coronary intervention (PCI) for the treatment of ischemic and/or valvular heart disease. Subjects who require or undergo PCI should undergo these procedures a minimum of 3 months in advance of randomization. Subjects who require or undergo CABG should undergo these procedures a minimum of 3 months in advance of randomization. In addition, subjects who develop a need for revascularization following enrollment should undergo revascularization without delay. Indication for imminent heart transplantation is defined as a high likelihood of transplant prior to collection of the 12 month study endpoint. Candidates cannot be UNOS 1A or 1B, and they must have documented a low probability of being transplanted.
  • Severe valvular (any valve) insufficiency and/or regurgitation within 12 months of consent
  • History of ischemic or hemorrhagic stroke within 90 days of consent
  • Presence of a pacemaker and/or implantable cardiac device (ICD) generator with any of the following limitations/conditions:
  • manufactured before the year 2000
  • leads implanted < 6 weeks prior to consent
Show all 30Show fewer
  • non transvenous epicardial or abandoned leads
  • subcutaneous ICDs (if not MRI compatible)
  • leadless pacemakers
  • any other condition that, in the judgment of device trained staff, would deem an MRI contraindicated
  • Pacemaker dependence with an ICD (Note: pacemaker dependent candidates without an ICD are not excluded)
  • A cardiac resynchronization therapy (CRT) device implanted less than 3 months prior to consent.
  • Other MRI contraindications (e.g. patient body habitus incompatible with MRI)
  • An appropriate ICD firing or anti tachycardia pacing (ATP) for ventricular fibrillation or ventricular tachycardia within 30 days of consent
  • Ventricular tachycardia ≥ 20 consecutive beats without an ICD within 3 months of consent, or symptomatic Mobitz II or higher degree atrioventricular block without a functioning pacemaker within 3 months of consent
  • Evidence of active myocarditis
  • Baseline glomerular filtration rate (eGFR) < 35 ml/min/1.73m2
  • Blood glucose levels (HbA1c) >10%
  • Hematologic abnormality evidenced by hematocrit < 25%, white blood cell < 2,500/ul or platelet count < 100,000/ul
  • Liver dysfunction evidenced by enzymes (AST and ALT) ˃ 3 times the ULN.
  • HIV and/or active HBV or HCV
  • Known history of anaphylactic reaction to penicillin or streptomycin
  • Received gene or cell based therapy from any source within the previous 12 months.
  • History of malignancy within 2 years (i.e., subjects with prior malignancy must be disease free for 2 years), excluding basal cell carcinoma and cervical carcinoma in situ which have been definitively treated.
  • Condition that limits lifespan to < 1 year
  • History of drug abuse (illegal "street" drugs except marijuana, or prescription medications not being used appropriately for a pre-existing medical condition) or alcohol abuse (≥ 5 drinks/day for ˃ 3 months), or documented medical, occupational, or legal problems arising from the use of alcohol or drugs within the past 12 months.
  • Participation in an investigational therapeutic or device trial within 30 days of consent
  • Cognitive or language barriers that prohibit obtaining informed consent or any study elements
  • Pregnancy or lactation or plans to become pregnant in the next 12 months.
  • Any other condition that, in the judgment of the Investigator or Sponsor, would impair enrollment, study product administration, or follow up.

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Roberto Bolli, MD contact

502-608-5426

rbolli@louisville.edu

United States3 sites, 3 recruiting
  • The Texas Heart Institute Houston Texas

    Houston, Texas, 77030

    Emerson Perin, MD, 832-355-9173, eperin@texasheart.org

    Nicole Piece, 832-355-9173, npiece@texasheart.org

    Recruiting
  • University of Louisville School of Medicine, Institute of Molecular Cardiology

    Louisville, Kentucky, 40202

    Roberto Bolli, MD, 502-608-5426, rbolli@louisville.edu

    Michelle Unseld, RN, 502-540-3423, michelle.unseld@louisville.edu

    Recruiting
  • University of Miami Miller School of Medicine

    Miami, Florida, 33136

    Joshua Hare, MD, 305-243-1152, JHare@med.miami.edu

    Ana Garzon, 305-243-1152, amg9460@med.miami.edu

    Recruiting

Other trials in United States

About this study

Official title: University of Louisville - 18642 / CATO Study, Single or Repeated Intravenous Administration of umbiliCAl Cord Mesenchymal sTrOmal Cells in Ischemic Cardiomyopathy

This is a Phase IIA, randomized, double blind, placebo controlled, multicenter study designed to assess the safety, feasibility, and efficacy of umbilical cord derived mesenchymal stromal cells (UC MSCs, stem cells), administered intravenously (IV) as a single dose or repeated doses, in patients with ischemic cardiomyopathy (ICM).

Read the detailed description

This is a Phase IIA, randomized, double blind, placebo controlled, multicenter study designed to assess the safety, feasibility, and efficacy of umbilical cord derived mesenchymal stromal cells (UC MSCs, stem cells), administered intravenously (IV) as a single dose or repeated doses, in patients with ischemic cardiomyopathy (ICM) (see summary in Figure 1).

A total of 60 participants will be assigned in a random fashion to three groups on a 1:1:1 basis: control, single dose, and repeated doses. All patients will receive four study product infusions (SPIs) 2 months apart. SPIs (performed in a double blind fashion) will consist of either UC MSCs (stem cells) or placebo (based on randomization), infused by the IV route. Patients in the control group will receive four doses of placebo. Patients in the single dose group will receive one dose of UC MSCs (stem cells) followed by three doses of placebo. Patients in the repeated dose group will receive four doses of UC MSCs (stem cells). A dose of UC MSCs will consist of 100 million cells suspended in 60 mL, infused at a rate of 2 mL/min. A dose of placebo will consist of an equivalent volume of Plasma Lyte A supplemented with 1% human serum albumin (HSA). After each SPI, patients will be monitored for a minimum of 2 hours and then examined at 1 week and 2 months. After the fourth SPI, patients will be followed for 6 months to complete all safety and efficacy assessments.

The UC MSCs will be derived from UC tissue obtained from a healthy pregnant woman at the time of caesarean delivery. The cells will be manufactured at the Interdisciplinary Stem Cell Institute at the University of Miami, Miller School of Medicine and then shipped to the Site for administration.

Being tested
umbilical cord-derived mesenchymal stromal cells (UC-MSCs)
Keywords
ischemic cardiopathy, UC-MSCs
Medical subject headings
Myocardial Ischemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • umbilical cord-derived mesenchymal stromal cells (UC-MSCs)Biological

    The study product will consist of 100 million UC-MSCs suspended in a final volume of 60 ml given at a rate of 3.3 million cells/min. The product will be infused into vein via intravenous line placed in the arm.

Study groups in NCT06145035
Study groupRoleWhat they receive
control groupPlacebo comparatorFour doses of vehicle (Plasma-Lyte A supplemented with 1% HSA) will be given 2 months apart. Each dose will be infused IV at a rate of 2 ml/min for a total of 60 ml over 30 minutes.
Receives: Biological: umbilical cord-derived mesenchymal stromal cells (UC-MSCs)
single-dose groupExperimentalOne dose of UC-MSCs (100 x 106 cells) will be infused IV at a rate of 2 ml/min for a total of 60 ml over 30 minutes (3.3 million cells/ml/min). This will be followed by three IV infusions of placebo (same volume and rate) 2, 4, and 6 months later.
Receives: Biological: umbilical cord-derived mesenchymal stromal cells (UC-MSCs)
repeated-dose groupExperimentalFour doses of UC-MSCs (100 x 106 cells each) will be given 2 months apart. Each dose will be infused IV at a rate of 2 ml/min for a total of 60 ml over 30 minutes (3.3 million cells/ml/min).
Receives: Biological: umbilical cord-derived mesenchymal stromal cells (UC-MSCs)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. change in LVEF (D LVEF) between baseline (M0) and 12 months after the first study product infusion (SPI) (M12)

    Change in left ventricular ejection fraction as assessed via cardiac MRI. Units: %

    Measured: Baseline, 12 months

Secondary outcomes (18)
  1. Change in LV end-systolic volume index (ESVI)

    Change in left ventricular end systolic index (LVESVI) as assessed via cardiac MRI.

    Units: ml/m2

    Measured: Baseline, 12 months

  2. Change in LV end-diastolic volume index (EDVI)

    Change in left ventricular end diastolic index (LVEDVI) as assessed via cardiac MRI.

    Units: ml/m2

    Measured: Baseline, 12 months

  3. Change in LV end-diastolic wall thickness

    Change in LV end-diastolic wall thickness as assessed via cardiac MRI. Units: mm

    Measured: Baseline, 12 months

  4. Change in LV wall thickening

    Change in LV wall thickening as assessed via cardiac MRI. Units: mm

    Measured: Baseline, 12 months

  5. Change in LV sphericity index

    Change in LV sphericity index as assessed via cardiac MRI. Units: Index score Sphericity index is the ratio of the long and short axis measurements of the left ventricle.

    Measured: Baseline, 12 months

  6. Change in global and regional strain (tagged MRI): global and 16-segment values for peak circumferential strain, global and segmental longitudinal strain

    Change in global and regional strain as assessed via cardiac MRI. Units: %

    Measured: Baseline, 12 months

  7. Change in scar mass (in grams)

    Change in scar mass (in grams) as assessed via delayed gadolinium enhancement MRI.

    Units: grams

    Measured: Baseline, 12 months

  8. Change in scar mass (as %LV)

    Change in scar mass (as %LV) as assessed via delayed gadolinium enhancement MRI.

    Units: %

    Measured: Baseline, 12 months

  9. Change in VO2 max (treadmill test)

    Change in maximal oxygen consumption (peak VO2) as assessed via treadmill. Units: mL/kg/min

    Measured: Baseline, month 8, month 12

  10. Change in exercise tolerance (six-minute walk test)

    Change in exercise tolerance as assessed as the distance covered via the six-minute walk test.

    Units: meters

    Measured: Baseline, month 8, month 12

  11. Change in New York Heart Association class

    NYHA Classifications of heart failure are as follows: Class I (no limitations); Class II (mild symptoms); Class III (marked limitations); Class IV (Severe limitations).

    Units: score on a scale

    Measured: Baseline, month 2,4,6,8, & 12

  12. Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score

    KCCQ is a 12-item questionnaire in which scores are scaled from 0 to 100 and summarized in ranges to represent health status as follows: 0 to 24: very poor to poor; 25 to 49: poor to fair; 50 to 74: fair to good; and 75 to 100: good to excellent.

    Units: score on a scale

    Measured: Baseline, month 6, month 12

  13. Change in Endothelial Progenitor Cell [EPC]-colony forming unit [EPC-CFU] assay

    Change in endothelial function will be reported as the change in Endothelial Progenitor Cell Colony Forming Unit (EPC-CFU) assessed via blood sample assay.

    Units: CFUs/well

    Measured: Baseline, month 2, 8, & 12

  14. Change in branchial artery flow-mediated dilation [FMD] [diameter percent change]).

    Change in branchial artery flow-mediated dilation will be reported as the percent change in flow mediated diameter assessed via flow mediated dilation (FMD).

    Units: %

    Measured: Baseline, month 2, 8, & 12

  15. Major adverse cardiac events (MACE)

    Number of participants with adjudicated events including death, hospitalization for worsening HF, and exacerbation of HF requiring visit to the Emergency Department and/or IV therapy but not requiring hospitalization.

    Units: number of participants who have an incidence of MACE in each group

    Measured: Month 12

  16. Cumulative days alive and out of hospital for HF

    Days alive and out of hospital during the study evaluation period. Units: days

    Measured: Month 12

  17. Biomarkers: Change in NT-proBNP

    Change in NT-proBNP as assessed via blood draw. Units: pg/ml

    Measured: Day 0, Month 2, 4, 6, 8, & 12

  18. Biomarkers: hs-CRP

    Blood level of hs-CRP as assessed via blood draw. Units: mg/ml

    Measured: Day 0, Week 1, Month 2, 4, 6, 8, & 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Nov 2023
  2. Study start4 Mar 2024
  3. Primary completion1 Jan 2028 (estimated)
  4. Study completion1 Sep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
randomized, double blind, placebo controlled,
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06145035
Sponsor's protocol ID
23.0712
Other IDs
1369707
Acronym
CATO
Status last verified
May 2026
First submitted
1 Nov 2023
Last updated
13 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bolli R, Tang XL, Hare JM, Mitrani RD, Perin EC, Lima JA, Hurwitz BE, Kalra D, Singh G, Saltzman RG, Caceres LV, Nettina A, Lee YS, Bacallao K, Grant E, Khan A. Design and rationale of CATO, a Phase IIA, randomized, double-blind, placebo-controlled study of single or repeated intravenous administration of umbilical cord-derived mesenchymal stromal cells in ischemic cardiomyopathy. Am Heart J. 2026 Apr;294:107328. doi: 10.1016/j.ahj.2025.107328. Epub 2025 Dec 13.

    PubMed 41397478
  • Tang XL, Wysoczynski M, Gumpert AM, Solanki M, Li Y, Wu WJ, Zheng S, Ruble H, Li H, Stowers H, Zheng S, Ou Q, Tanveer N, Slezak J, Kalra DK, Bolli R. Intravenous infusions of mesenchymal stromal cells have cumulative beneficial effects in a porcine model of chronic ischaemic cardiomyopathy. Cardiovasc Res. 2024 Dec 4;120(15):1939-1952. doi: 10.1093/cvr/cvae173.

    PubMed 39163570

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in people with Ischemic Heart Disease, run by Roberto Bolli at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 13 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Roberto Bolli, MD (502-608-5426, rbolli@louisville.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

change in LVEF (D LVEF) between baseline (M0) and 12 months after the first study product infusion (SPI) (M12) (time frame: Baseline, 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06145035, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 May 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in