Dr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart in his Ask the Cardiologist series. To see all posts Dr. Malinski has written, just type “Ask the Cardiologist” into the search bar on the right.
Yesterday, we published news of an intriguing study from across the pond, where British scientists are working on cardiac cells in mice in an effort to help the human heart during and after a heart attack.
Biologically speaking, there are very few similarities between mice and humans. So we avoided the subject of mice and simply asked Dr. Malinski the question that we came away with after reading the study.
Q: Is heart regeneration possible in humans?
A: Concerning a heart attack and the subsequent damage done to the heart, treatments are currently focused on rapid restoration of blood flow to limit the damage done by lack of oxygen in heart muscle tissue. Lack of oxygen causes damage and dysfunction in the left ventricle (LV), leading to congestive heart failure and electrical problems causing sudden cardiac death. There are medical therapies that can reduce the progression of heart dysfunction, but the process of self-repair (or regeneration, as you say) is currently not very effective.
The part of the heart tissue that is damaged or dead after a heart attack remains so for life, and our therapies are focused on secondary prevention to decrease the probability of additional cardiac events that would only do more damage.
So-called regenerative medicine is a fairly new field that is developing rapidly since the advances in genetic science expanded our understanding of cell development and genetically programmed function. There are many studies looking at regenerative possibilities of endothelial progenitor cells.
I’ll pause here and explain what endothelial progenitor cells are, since that’s a headspinning term. In a nutshell, if a patient has higher levels of these cells, he or she will be less likely to have repeat cardiac events. The cells promote growth of new vessels (a process called neovascularization), which predicts better patient outcomes.
There are many trials showing the benefits of therapies with endothelial progenitor cells showing that damage to the heart is limited during an acute cardiovascular event. There are also studies showing the promise of reversal of the damage done by heart attack with the possibility of restoration of the function of damaged tissue. Medical scientists are working also on technical aspects of cell therapies, i.e. how to deliver these cells to the site of the injury.
There is some great promise that we are entering a new era of medicine, but nobody can predict how we are going to treat patients with heart attacks in 5-10 years. We have to remember that even the era of “reperfusion” (the opening of occluded heart arteries with angioplasty and stenting) is a fairly new practice, and has been used for barely 20 years. The first human angioplasty was performed 1974, the first cath lab based angioplasty on awake patients was done in 1977, and the FDA approved use of stents in 1994.
In response to your question, we still need more research on how to optimize cell-based therapy, and to prove its clinical effect with respect to outcomes like decreasing death. But this is a field of accelerated research that every year brings new advances, and with them hope to our patients of better care and life.
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This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.