Thursday, January 22, 2009

Research Study Looks At Alternative to Heart Transplant

By Michael Lasalandra
Beth Israel Deaconess Medical Center Correspondent

About 1.2 million Americans suffer heart attacks each year, with about 450,000 of them dying as a result. Of those who survive the initial attack, 400,000 end up with heart damage so severe that the heart cannot pump enough blood to meet the body’s needs.

While the condition, known as congestive heart failure, can often be managed with medications, about half of all sufferers still die within five years. For some, heart transplantation is the only option.

But only about 2,200 patients get heart transplants every year. There are always about 3,000 patients on a waiting list for a new heart. And those lucky enough to get transplants must take drugs that suppress their immune systems for the rest of their lives. The drugs come with a host of serious side effects.

Now, researchers at Beth Israel Deaconess Medical Center are investigating another option that may allow those suffering congestive heart failure to repair their damaged hearts -- using tissue taken from those very hearts themselves.

“This could be a better way,” says Dr. Roger Laham, Director of Basic Angioplasty Research at BIDMC. “Congestive heart failure is the leading cause of morbidity if not mortality in the U.S. We have effective ways to treat patients with heart attacks. They usually survive, but they have suffered damage to the heart. Years later, they develop heart failure. Their lungs fill up with fluid. They die of sudden death.”

Dr. Laham’s team has developed a method to transplant tissue from areas of the heart that are not damaged to areas that are damaged. “There are always areas of the heart that are preserved,” he says.

In animal studies, the technique proved remarkably successful.

“We were surprised by the result,” he says. “We were able to reduce the size of the heart attack (damage), improve the function of the heart and improve the cells inside the heart itself.”

Function improved by about 25 percent.

Human studies are expected to get underway within six months.

“We’re very excited about it,” says Dr. Laham, whose research team has been working on finding ways to get the heart muscle to regenerate itself for the past eight years. The initial idea was to take cells from the blood and bone marrow and deliver them to the damaged heart muscle. Later, they decided to also try taking pieces of sections of the healthy heart muscle itself and transplant them into the damaged parts of the muscle. The heart and brain are known as the only two organs that cannot regenerate themselves on their own when damaged.

The pieces taken from the healthy sections of muscle are removed much as they are for biopsy. Six or seven small pieces each about the size of a matchhead are removed and transplanted into damaged sections. The transplanted tissues repair the damaged tissues by delivering not only healthy tissue, but also stem cells and proteins needed for regeneration.

Access is by catheter, so there is no open-heart surgery required.

Details on the process were revealed at recent meetings of the American Heart Association and American College of Cardiology. A paper has been submitted to the journal Circulation.

Above content provided by Beth Israel Deaconess Medical Center.
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