Heart Failure

The term “heart failure” is sometimes incorrectly used to describe other cardiac-related illnesses, such as myocardial infarction (heart attack) or cardiac arrest, which can cause heart failure but are not equivalent to heart failure.

Conditions that can cause heart failure include heart attacks, high blood pressure, heart valve disorders, irregular heartbeat, and diabetes.  Heart failure can develop because blood vessels to the heart are blocked by plaque or cholesterol buildup. It can also develop because muscles have become too stiff due to other heart diseases to pump efficiently.  Lifestyle habits can also damage blood vessels to the heart, and over time can lead to ischemia.

The term “heart failure” makes it sound like the heart is no longer working at all and there's nothing that can be done. Actually, heart failure means that the heart isn't pumping as well as it should be.  Many people living with heart failure lead a full, enjoyable life, but it is a serious condition, and usually there's no cure.

 

Human and Social Costs

Heart failure is a common, costly, disabling, and potentially deadly condition. In developed countries, around 2% of adults suffer from heart failure, but in those over the age of 65, this increases to 6–10%.

 

Potential for Cures

Many forms of cardiovascular disease could benefit from stem cell research including: heart failure, heart attacks and peripheral vascular disease.

There is promising news for people at risk of heart failure.  Researchers have just recently found that stem cell therapy in humans has been surprisingly successful in replacing damaged muscle and getting the heart to pump better.

The diverse literature on stem cell research comprises the work of basic and clinical scientists from many different subspecialties.  Certain landmark findings and concepts have shaped our understanding of what may be accomplished and what potential mechanisms may be explored to achieve clinically successful results in the near future.  [Circulation, Mini-Review: Expert Opinions]

Asahara et al in 1997, provided the first evidence that cell therapy may constitute a therapeutic option for the treatment of ischemic disease. They who showed that bone marrow–derived CD34+ cells can give rise to endothelial-like cells and improve neovascularization after ischemia.

Initial animal studies used isolated neonatal cardiomyocytes to replace dead muscle tissue.  However, because of the limited availability of mature human cardiomyocytes, skeletal muscle cells were considered as an alternative cell source, which indeed improved cardiac function after transplantation of the cells in animal models.

 

Recent Advancements

There is promising news for people at risk of heart failure after US researchers have found stem cell therapy in humans has been surprisingly successful in replacing damaged muscle and getting the heart to pump better.

  • Clinical trials have shown that treating patients who have chronic and severe heart failure with a special kind of adult stem cell—a mesenchymal precursor cell (MPC)—in this case, from a healthy young donor, significantly reduces the patients' chance of death and major adverse cardiac events (known as MACE). The study also showed that, for those who received these stem cells in the highest doses, researchers were able to completely prevent any episodes of heart failure hospitalization during 18 months of follow-up.   [ABC, Nov. 17th, 2011]
  • Stem cells obtained from bone marrow, known as BMCs, can be safely injected into people 2-3 weeks following a heart attack, reports a new clinical trial supported by the National, Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. This was the first trial to rigorously examine the safety and potential benefits of extending the timing of stem cell delivery to 2-3 weeks following a heart attack. While the treatment was found to be safe, the BMCs did not improve heart function six months after their administration. However, study participants will continue to be evaluated for two years, so the BMC therapy may yet demonstrate health benefits such as a lower risk of subsequent heart attacks or heart failure. [ScienceDaily, Nov. 16, 2011]
  • Professor Roberto Bolli from the University of Louisville, and Professor Piero Anversa from Harvard Medical School, and their research teams are bearing out original work conducted at the Texas Heart Institute. Their clinical study of 16 patients presented at the recent 2011 Annual American Heart Association meeting, confirmed the promise of stem cell therapy using a stem cell resident in the heart. [University of Louisville, Nov. 14th, 2011]  [NBC Nightly News, Nov. 14th, 2011]   [CNN, Nov. 14th, 2011]
  • Scientists have developed a new technique that could lead to a potentially inexhaustible supply of cells for research and drug discovery. The researchers, working at Monash University are using a new technique that allows scientists to isolate and study heart cells grown from the stem cells of heart disease patients and model heart disease in a Petri dish. The team is using similar strategies to isolate insulin-producing cells for the treatment of diabetes and blood cells for the treatment of leukemia. [Australian Life Scientist, Oct. 24th, 2011]
  • SCIPIO Trial showed cardiac stem cells benefits heart failure patients. SCIPIO trial made headlines after demonstrating that intracoronary infusion of c-kit-positive cells in patients with ischemic cardiomyopathy led to reduction in infarct size by 24% at six months and 30% at one year.

 

Educational Videos

KXAN Report Nov. 14th, 2011 : Healing Damaged Hearts with Stem Cells

Austin Forum: “Stem Cell Therapy in the Treatment of Patients with Ischemic Heart Failure”

Repairing the Heart: The Possibility of Cell Therapy