Transplantation of bone marrow cells into a severely damaged heart may be a new way to treat heart disease patients who have exhausted all other treatment options, researchers report.
The treatment also improved the heart’s ability to pump blood and restored blood flow to oxygen-starved heart muscle, says Hung-Fat Tse, MD, an associate professor of medicine and deputy director of the Research Center of Heart, Brain, Hormone, and Healthy Aging at the University of Hong Kong.
If findings of the small study pan out in future research, it could mean a new treatment option for the thousands of Americans with severe buildup of atherosclerotic plaque in their arteries, severe chest pain, and no other treatment options for coronary artery disease.
The study was presented here at the annual meeting of the American College of Cardiology.
Cells Taken From Bone Marrow
The 28 people in the study suffered from severe coronary artery disease that did not respond to conventional treatment.
The participants were the sickest of the sick. They failed to respond to medication and for one reason or another could not be helped by surgery used to clear clogged arteries -- coronary bypass surgery or angioplasty procedures. Many had significant symptoms of heart disease that made it so they could barely walk across the room without panting.
"The heart disease in these patients follows an inexorable downhill course with disabling symptoms and progressive cardiac failure,” Tse says.
The cells used in the study were taken from the patients' own blood cell factory -- the bone marrow -- several hours before the procedure.
Functional Living Improves After Transplant
In the study, 19 people received an average of 15 injections containing either 1 million or 2 million bone marrow cells directly into oxygen-deprived areas of the heart. These bone marrow cells are believed to spur growth of new blood vessels in the injured heart muscle.
Nine other patients served as a comparison group and received injections of a placebo substance.
After six months, people who were treated with bone marrow cells could exercise on a treadmill for 20 percent longer than those on placebo. They had less chest pain, and they could perform everyday activities easier, such as going to the store.
Ejection fraction, a measure of the heart’s pumping ability, improved by 7.5 percent compared with placebo. And heart imaging studies showed that people who got the bone marrow cells had 30 percent less oxygen-starved heart tissue than their untreated counterparts.
Matthew R. Wolff, MD, chief of the division of cardiovascular medicine at the University of Wisconsin School of Medicine in Madison and co-chairman of the committee that chose which studies would be highlighted at the meeting, says, “The findings are very encouraging for a first shot.”
This is believed to be one of the first studies pitting direct injections of bone marrow cells into human hearts against injections of placebo substances, he tells WebMD. But the small number of people in the study means there’s still a lot of work to do before the treatment is ready for prime time.
Wolff says he thinks injecting the cells directly into the heart muscle gives the approach the edge over some earlier studies that injected cells into the heart arteries.
“Early evidence suggests that when you inject the cells into the coronary artery, as few as 2 percent end up in the heart,” he says. “Directly injecting them into heart muscle gives them a much greater chance of getting to where they are needed to repair the damage.”
By Charlene Laino, reviewed by Brunilda Nazario, MD
SOURCES: American College of Cardiology annual meeting, Atlanta, March 14, 2006. Hung-Fat Tse, MD, associate professor of medicine, deputy director, Research Center of Heart, Brain, Hormone and Healthy Aging, University of Hong Kong. Matthew R. Wolff, MD, chief, division of cardiovascular medicine, University of Wisconsin School of Medicine, Madison; co-chairman, ACC meeting.