CardioCell, a stem cell company in San Diego, has started a Phase 2a clinical trial of its treatment for chronic heart failure.

The companys special stem cells are injected into patients with heart failure not caused by a heart attack. Nearly 2 million Americans have that kind of heart failure.

Separately, CardioCell is testing these stem cells on heart attack patients.

The cells are licensed from Stemedica, the parent company of CardioCell.

Taken from bone marrow, the stem cells produce chemicals intended to heal malfunctioning heart cells. They are grown under low-oxygen conditions, or hypoxia. CardioCell said hypoxia reflects the conditions under which natural stem cells exist.

Also in San Diego, the company Histogen is developing its own type of low-oxygen stem cells.

Growing stem cells with abundant oxygen reduces their stemness, and they become prone to differentiation turning into other types of cells, said Sergey Sikora, CardioCells president and chief executive.

More than 20 patients are being sought for the Phase 2a trial, which is taking place at Emory University in Atlanta, Northwestern University near Chicago and the University of Pennsylvania in Philadelphia.

Patients receive injections of the stem cells, while a control group receives a saline injection. After 90 days, the groups treatment will be reversed.

The stem cells live for about a month, Sikora said.

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TESTS ADVANCE FOR CARDIOCELL MEDICINE