Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Stem cells given in minimally invasive procedure improve heart function

26.01.2005


University of Pittsburgh researcher reports results of randomized trial of new approach at Society for Thoracic Surgery meeting



Patients with severe congestive heart failure who had exhausted all other treatment options showed markedly improved heart function following a procedure in which their own stem cells were deployed directly into the heart by way of four tiny incisions in the chest, according to results of a trial presented today at the 41st Annual Meeting of the Society for Thoracic Surgery. The study, led by Amit N. Patel, M.D., M.S., of the University of Pittsburgh McGowan Institute for Regenerative Medicine, is the first to use a minimally invasive surgical technique.

While preliminary, the results of the prospective randomized trial indicate that a minimally invasive approach to cell therapy is feasible for the estimated 40 percent of heart failure patients whose disease is unrelated to coronary blockages and who therefore cannot benefit from bypass procedures. Moreover, the experience so far suggests the novel stem-cell approach may be a viable treatment for these and other heart failure patients, reported Dr. Patel, director of clinical cardiac cell therapies at the McGowan Institute.


All 15 of the patients who received stem cell injections had some degree of improvement, some with dramatic results, while the conditions essentially remained unchanged in the 15 randomized to receive injections of their own blood serum. "It is remarkable the level of improvement we’ve seen in these patients, who came to us with no other medical or surgical options available to them. However, we don’t yet fully understand how these cells work, whether they differentiate to become heart muscle cells or cells that promote vessel growth, or whether they serve as homing signals to other cells and substances that help with repair," explained Dr. Patel.

The study took place at centers in South America. The research team obtained the necessary institutional and government health agency approval and each patient provided informed consent.

All 30 patients enrolled had severe heart failure (New York Heart Association heart failure classifications III and IV) with ejection fraction rates of less than 35 percent. Ejection fraction is a standard measure of heart function and is determined by the total amount of blood that the left ventricle pumps out per heart beat. A patient with good heart function has an ejection fraction of at least 55 percent.

Patients were scheduled to undergo the minimally invasive procedure but were unaware whether they would receive their own bone marrow stem cells or their own serum. Regardless, while under general anesthesia, each patient had bone marrow harvested from their hipbones. The cells believed to have the greatest therapeutic benefit, CD34+ cells, were isolated from the bone marrow and either injected into the hearts of patients randomized for therapy or placed in frozen storage if the patients were randomized to the control group. These patients received the same number of injections into the heart – about 25 to 30 – as the patients in the treatment group but instead of containing their stem cells, the injections were loaded with their serum. Neither group experienced any significant side effects or complications, including abnormal heart rhythms, which had been associated with other stem cell trials.

Prior to the study, the two groups had comparable ejection fraction rates. The treatment study group had an average rate of 26 percent, with the range between 21 and 34 percent, and the control group averaged 27 percent, with the range being 22 to 34 percent. Yet six months later, those receiving stem cells improved to an average rate of 46 percent, the lowest rate of improvement going up to 38 and the highest climbing to 52 percent. By comparison, the control patients average went up one percentage point, to 27, with a range between 22 and 31, indicating that some had worsening heart function.

With a six-month follow-up period now complete, the patients who had been randomized to receive the placebo treatment are now eligible to receive their own bone-marrow stem cells that had been kept frozen.

Last April, Dr. Patel reported the results of a trial looking at stem cell therapy given in conjunction with beating-heart bypass surgery for patients whose hearts were damaged by heart attack or chronic coronary disease. That study involving 20 patients also demonstrated the potential benefits of using a patient’s own bone marrow-derived stem cells to treat their ischemic heart disease.

Dr. Patel and his colleagues are in discussions with the U.S. Food and Drug Administration and hope to receive the agency’s approval to conduct a trial at the University of Pittsburgh that would involve giving stem cells to patients who are being implanted with heart assist devices. When a donor heart becomes available for transplantation, the native heart would be removed, allowing researchers the rare opportunity to look at the heart in its entirety and to more closely examine the effects of the stem cells.

If approved, the protocol will be performed under the umbrella of the newly established Center for Cardiovascular Cellular Therapy, a collaboration that includes the McGowan Institute, the University of Pittsburgh School of Medicine’s department of surgery, the University of Pittsburgh Schools of the Health Sciences and the University of Pittsburgh Medical Center. The center will encompass clinical and research programs focused on the use of stem cells as an adjuvant treatment for a wide array of heart failure patients and for those with peripheral vascular disease.

In addition to Dr. Patel, co-authors of the current research include Federico Benetti, M.D., and Luis Geffner, M.D., of the Benetti Foundation in Rosario, Argentina; Roberto Paganini, M.D. and Daniel Brusich, M.D., of Asociacion Espanola Primera de Socorros Mutos in Montevideo, Uruguay; Robert L. Kormos of the University of Pittsburgh’s McGowan Institute; and Harold C. Urschel, Jr., M.D., of Baylor University Medical Center in Dallas.

Lisa Rossi | EurekAlert!
Further information:
http://www.upmc.edu

More articles from Life Sciences:

nachricht BigH1 -- The key histone for male fertility
14.12.2017 | Institute for Research in Biomedicine (IRB Barcelona)

nachricht Guardians of the Gate
14.12.2017 | Max-Planck-Institut für Biochemie

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Plasmonic biosensors enable development of new easy-to-use health tests

14.12.2017 | Health and Medicine

New type of smart windows use liquid to switch from clear to reflective

14.12.2017 | Physics and Astronomy

BigH1 -- The key histone for male fertility

14.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>