Stem cell treatments for damaged hearts, heart disease and heart failure are closing in on revolutionary developments that not only repair damaged hearts but also eliminate the need for anti-rejection drugs. The newest discoveries range from trials at Cedars-Sinai Medical Center in Los Angeles, Stanford University, Louisville’s Jewish Hospital, the University of Buffalo and the UH Case Medical Center. The implications are far reaching and clearly demonstrate the advances in treatments for numerous stages of heart disease.
On Monday, the Louisville Jewish Hospital and Cedars – Sinai of Los Angeles revealed startling results in studies using the patient’s stem cells to successfully rebuild the muscle and improve the Left Ventricle Ejection Fraction (LVEF), the gauge of the heart’s capacity to pump blood with each contraction.
Dr. Bolli led the study in Louisville. Dr. Eduardo Marban directed the Cedars-Sinai stem cell program. Combined with other studies, the exploratory stem cell treatment included 60 patients suffering various stages of heart disease.
Bolli’s study included 16 patients who all received cardiac stem cells. Another seven patients received no stem cells. Over a period of one-year, the seven patients not receiving stem cells but receiving conventional treatment showed no improvement. In the patients receiving stem cells the average left ventricle ejection fraction (LVEF) was 30 percent. After one year, the stem cell recipients improved the average LVEF to 42.5 percent.
For those of us who have become edgy as our LVEF continuously decreased, these developments seem quite miraculous. To be qualify for heart transplantation, recipients typically must have an ejection fraction below 12 percent. Typically, patients with a higher LVEF can qualify for a heart transplant program but may have a long wait before actually receiving an organ.
Remember that the current transplant mindset is that the longer you have your own heart, the better you are. I did not always feel that way, but after a difficult recovery, I certainly see the logic. On the other hand, my children always remind me of how I felt prior to the transplant. Not very well!
As Dr. Bolli explained when we enter congestive heart failure and end stage heart disease conventional treatment does not produce improvement. My cardiologist described the end stage as being on a hill that looks steeper every day. There is only one direction to go and that is down the hill. The descent can be rapid or slow but there has never before been a way to reverse the trend.
The idea that one’s LVEV can show such dramatic improvement almost seems inconceivable. In the Louisville study, Mike Jones suffered a severe heart attack two years ago. With conventional care, Jones was falling down the hill at a rapid pace.
The infusion of stem cells into his coronary arteries yielded big returns. Bolli’s procedure showed that this treatment not only halted the downward spiral but also rebuilt the damaged heart. Jones was doing the unthinkable. He was climbing the hill. Jones needed no anti-rejection medications and suffered no dangerous side effects.
Before the stem cell infusion, Jones could barely walk without having to stop to catch his breath. He is now back to work and even playing baseball with his children and grandchildren. Miraculous!
At Cedars-Sinai, Ken Milles was among 17 patients who received stem cell infusions six weeks after suffering moderate to major heart attacks. All patients were described as being “at big risk” of future heart failure.
In Miles, the damaged scar tissue was reduced by 40 percent. In other patients the range was between 30 and 47 percent. Dr. Marban said, “This is unprecedented, the first time anyone has grown living heart muscle.”
The best news is that no patients in the study have suffered any further heart failure. Wow!
A third study conducted by Dr. Dan Simon of UH Case Medical Center suggests that the sooner the stems cells are infused, the more successful the treatment. Patients who were infused three weeks after the heart attack did not enjoy the same level of success as those who received the stem cell therapy almost immediately after the event.
Milles’ observations were interesting. When his cells were extracted from inside the heart, he definitely felt the action. A few weeks later, the expanding stem cells were infused in a procedure similar to angioplasty.
When I was first admitted to Columbia Presbyterian, I volunteered for their stem cell research program. Dr. Mancini informed me that because of my previous open-heart surgery I could not be considered for the program. One of the appealing aspects was that the patient did not have to wait for an organ. Had I been an acceptable candidate, I would have started the treatment immediately.
At Stanford, real cases showed that the use of the patient’s stem cells to repair the kidneys safely eliminated the need for anti-rejection medications. The stem cells administered to the kidney caused the kidneys to increase their effectiveness and replace damaged areas.
The University of Buffalo
The University of Buffalo submitted a report to the Scientific Sessions of the American Heart Association in Orlando on May 15th. The report proved that stem cells administered to the damaged hearts in animals repaired heart function by an average of 30 percent.
John M. Canty Jr. MD and Elizabeth Rekatee, Professor of Medicine presented their research in Orlando. In describing the results of their study, Canty explained, “Whereas most research has focused upon irreversible damage and scarring following a heart attack, we have shown that a single CDC (cardiosphere-derived cells) infusion is capable of improving heart function is areas of the heart that are viable but not function normally.”
Canty added that stem cells extracted in biopsies on the animals will expand outside the body. The cells are then infused into the coronary arteries of the same animal suffering from heart failure. The new cells are small but function significantly better than the damaged cells.
Combining this data to the amazing windpipe transplant in Sweden, there is no doubt that this is the direction heart failure will be treated. Soon, the whole transplantation process will be re-evaluated. If I had not received this precious gift and was still waiting, I would try to enter one of the stem cell research programs.
Congratulations to all who have participated and developed these remarkable advancements in heart care.