Tuesday, 27 March 2012

Stem cells the only alternative in end stage heart failure

By Syed Akbar
Hyderabad:  Patients with end stage heart failure need not
despair any longer. A team of cardiologists led by eminent heart
specialist Dr KM Cherian has successfully improved the heart condition
of dozens of patients, who otherwise did not respond to any kind of
treatment.

In the last three years as many as 56 patients with end stage heart
failure received stem cell therapy. The functioning of their heart
showed considerable improvement and many of them are leading a normal
life, doing their daily chores.

The medical breakthrough achieved by Dr Cherian and his team was
presented at the ongoing international conference on stem cells and
regenerative medicine at the Indian School of Business here. Dr
Cherian, who could not attend the conference, is the founding chairman
of Frontier Lifeline Hospital and Dr KM Cherian Heart Foundation in
Chennai. He is credited with performing India’s first coronary artery
bypass surgery 37 years ago.

The patients, who underwent stem cell therapy, were not fit for
maximal medical therapy, angioplasty, ventricular remodeling, coronary
artery bypass or cardiac resynchronization Therapy (CRT) devices. The
only alternative left for them was to undergo heart transplant. As the
need for transplantable heart far outweighs the availability supply,
the patients opted for stem cell therapy, which had improved their
lives.

According to the presentation, post stem cell therapy follow-ups were
performed with echocardiography (ECG) and revaluations of B-type
Natriuretic Peptide (BNP) levels and signs and symptoms after three
months, six months and one year. There was no procedural mortality or
complications.

Three patients, who were suffering from severely deranged cardiac
function and single or double graftable coronary arteries, underwent
mesenchymal stem cell injection into the myocardium. Seven patients
had endothelial progenitor cell injection into the coronary or into
the myocardium directly, by catheter or by surgery respectively. A
large group of 42 patients received autologous bone marrow mononuclear
cells (MNC) in their heart by catheter or surgical interventions.

“All patients tolerated the procedure well. Viability of MNCs was
about 99 per cent. Ejection fraction increased in 97 per cent of
patients. Symptomatically all the patients did fairly well. In seven
patients post therapy first follow up showed regression in Mitral
regurgitation, and the mitral annular size. All these improvement
showed a slow rise till the sixth month after which improvement in13
patients declined,” the presentation said.

The team noted that cardiac stem cell therapy is a safe therapeutic
tool for the no-option cardiac failure patients. It can be a tool for
bridge to transplant. Monitoring of all the patients’ data shows that
repeated therapy at an interval of six months may be a practiced
modality of treatment.

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