A step for cardiac regeneration

Heart failure is a common, disabling and deadly. The most common cause of heart failure in developed countries is ischemic heart disease, a blockage of blood vessels of the heart that causes the death of heart muscle tissue. This causes the heart to pump less blood, resulting in a decrease in left ventricular ejection fraction (LVEF). Available treatments, say the authors of the paper, do not address the fundamental problem of loss of heart tissue.

It is known that the heart contains adult cardiac stem cells with the ability to self-renew and cloned. Furthermore, say the authors of the study published in The Lancet , Roberto Bolli, University of Louisville (USA). and Piero Anversa, of Brigham and Women's Hospital of Harvard University (USA), these cells are multipotent, ie they differ in the three main cardiac lineages (myocytes, vascular smooth muscle cells and endothelial cells).

In animal models of cardiac stem cells have demonstrated ability to improve heart failure, but so far not been tested in humans. In this study, the authors conducted a Phase 1 in patients with heart failure after a heart attack to assess the safety and feasibility of intracoronary infusion of cardiac stem cells and test the hypothesis that well this intervention could improve the contractile function of heart and the patient's overall clinical status

The trial, called Scipio , was conducted in 23 patients with severe heart failure who had undergone coronary artery bypass surgery. A total of 16 received cardiac stem cells, while the other seven (control group) received standard treatment. Patients received an infusion of 1 million cardiac stem cells for an average of 4 months after CABG.

The results showed that in 14 patients treated with this procedure, we observed an increase in the proportion of 30.3% before infusion to 38.5% at 4 months after infusion. In the control group did not change.

Positive

The researchers stress that the positive effects of cardiac stem cell infusion were even more pronounced each year in eight patients, in which the left ventricular ejection fraction increased by 12.3% (from 30.2% before infusion to 42.5% at 1 year). In the seven patients treated who underwent an MRI, the size of dead tissue (infarction) was reduced by 24% at 4 months and 30% a year.

The authors stress that this is the first study to demonstrate that the management of cardiac stem cells is effective and introduces a potential new treatment for heart failure. "The results provide a solid foundation for designing future studies on the use of cardiac stem cells like treatment for patients with severe heart failure secondary to ischemic cardiomyopathy have a poor prognosis. "