Heart Failure
Introduction
Heart attacks and congestive heart failure remain among the largest healthcare burdens worldwide. Congestive heart failure is basically an inability of the heart to pump blood to the various parts of the body. This is caused by the loss or dysfunction of heart muscle cells. It affects 4.8 million people, with 400,000 new cases each year. One of the major contributors to the development of this condition is a heart attack, known medically as a myocardial infarction, which occurs in nearly 1.1 million Americans each year. Recent research is providing early evidence that adult and embryonic stem cells may be able to replace damaged heart muscle cells and establish new blood vessels to supply them.
In a breakthrough study 16 heart failure patients given stem cells taken from their own bodies showed dramatic and lasting improvement.
Iranian scientists have moved to the forefront in embryonic stem cell research, according to a recent joint study by Harvard University and the Massachusetts Institute of Technology
Stem cells are primitive cells in the body that have the capacity to become any cell. Stem cells and bone marrow cells have been used since 1968 in patients with blood cancers like leukemia, aplastic anemia, lymphomas such as Hodgkin’s disease, multiple myeloma and even in ovarian and breast cancers.
Many of these stem cells can come from the cord blood or the blood in the umbilical cord that joins the baby to the mother in the womb. After birth the cord blood can be collected and processed to make stem cells into the desired cells. These cells can help in development of new blood vessels, increase the number of new cells
Treatment
In patients with heart failure these stem cells are coaxed to form cardiomyocyte, the heart muscle cell that contracts to eject the blood out of the heart’s main pumping chamber (the ventricle). Two other cell types are important to a properly functioning heart are the vascular endothelial cell, which forms the inner lining of new blood vessels, and the smooth muscle cell, which forms the wall of blood vessels. The potential capability of both embryonic and adult stem cells to develop into these cells types in the damaged heart is now being explored as part of a strategy to restore heart function to people who have had heart attacks or have congestive heart failure.
In a breakthrough study 16 heart failure patients given stem cells taken from their own bodies showed dramatic and lasting improvement. Researcher Dr. Roberto Bolli, director of cardiology at the University of Louisville in Kentucky adds that although this was a small scale study if the finding is confirmed in additional studies, “It could offer an entirely new option and a potential cure for patients who are now dying from heart failure.”
The study appears in The Lancet and was presented at an American Heart Association meeting in Orlando, Fla. The team of researchers harvested stem cells from the patients’ hearts during bypass surgery at Jewish Hospital in Louisville. All of the patients had severe heart failure, as shown by measurements of how much blood the heart’s main pumping chamber, the left ventricle, was able to “eject” or pump out with each contraction. The patients all had a left ventricle ejection fraction (LVEF) of 40 percent or lower. An ejection fraction of 50 percent or higher is considered normal.
The stem cells were purified and allowed to grow in number, and then re-infused into the regions of the patients’ hearts that had been scarred by their heart attacks. Four months after the re-infusion, the LVEF of the patients who had gotten the stem cells rose from 30.3 percent to 38.5 percent. One year after re-infusion, eight of the patients showed even more dramatic improvement.
Further MRI scans of the patients’ hearts show that the area of scarring had fallen significantly in those who had gotten the stem cell treatment. That finding seems to disprove the long-held belief that once scarring occurs, the heart tissue is forever dead.