Stem Cells Can Treat End-Stage Heart Failure

A study has demonstrated that injecting a person's own stem cells directly into heart muscle appears safe and useful in treating end-stage heart failure. The results were published April 21, 2003, in the online issue of Circulation.

The study involved 21 Brazilian patients with a high risk of dying and with no other therapy available because their heart failure was so severe. The researchers injected about two million stem cells in each of 14 patients, while the other seven patients served as a control group. The patients received a stem cell called a bone marrow mononuclear cell, drawn from their own bone marrow about four hours prior to the procedure. These cells carry a marker protein on their surface called CD34 that allowed the researchers to identify them. They were chosen because of their high probability of becoming blood-
vessel cells.

The actual procedure involved threading a catheter through an artery into the left ventricle and "mapping” specific sites of muscle damage. The stem cells were injected into these areas. After two months, the treated patients had significantly less heart failure and angina, and were more able to pump blood than the untreated patients. The treated group also tended to do better on treadmill tests. After four months, the treated patients had a sustained improvement in pumping power and ability to supply blood to the body. None of the treated patients had serious problems. All went home after three days. One treated patient died after 14 weeks.

The reason for the improvement remains uncertain. "Either these stem cells became new blood vessel and new heart muscle cells, or their presence stimulated the development of one or both,” said senior author James T. Willerson, M.D., president of the University of Texas Health Science Center (Houston, USA; www.med.uth.tmc.edu). Some patients were treated in Texas and some in Rio de Janeiro (Brazil).




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