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Regenerative Medicine for Heart Failure

Approximately 5.7 million adults in the U.S. have been diagnosed with heart failure. Unfortunately, only half of those diagnosed with heart failure are still alive 5 years after their diagnosis (1).

Current therapies improve a patient’s quality of life but cannot cure the condition. Heart transplants are the only treatment that can significantly increase the life expectancy and quality of life, but there are many risks with a surgery of that magnitude and a severe shortage of available hearts. There is hope, though. Researchers have found that stem cell therapy is both safe and effective in treating heart failure.


Heart Failure - Temecula Center for Integrative Medicine

The Basics of Heart Failure


The term “heart failure” sounds like your heart has stopped working, but it actually means that a heart does not pump blood as efficiently as it should. As a result, your heart does not move enough blood through your body to provide it with enough oxygen and nutrients. This will often cause blood and fluids to build up in your heart, lungs, extremities, kidneys, and abdomen. When fluid begins to build up, this is called congestive heart failure. The earlier congestive heart failure is treated, the easier it is to manage and slow its progression.


Fatigue, swelling in your ankles, feet, or legs, weight gain, edema, and increased urination are early symptoms of heart failure. As the condition worsens, normal physical activity may cause shortness of breath, fatigue, and heart palpitations. You may also notice a persistent cough or wheezing from congested lungs. Severe congestive heart failure may cause chest pain that radiates through your upper body, fainting, rapid breathing, and a blue tinge to your skin.


There can be many different causes and contributing factors to the development of heart failure. High blood pressure, coronary artery disease, genetics, a heart attack, thyroid disease, diabetes, kidney disease, and heart defects present at birth can increase your risk of heart failure. Even seemingly unrelated issues like allergic reactions and severe infections may play a role in the development of heart failure.


To make it even more complicated, there are also a few different types of heart failure. Since every person is different and heart disease can have many contributing factors, it may be difficult to find a treatment regimen that works to slow the progression and minimize symptoms.


Traditional therapies include medications and surgery. Commonly used medications are ACE inhibitors and vasodilators which open up blood vessels to improve blood flow, beta-blockers which reduce blood pressure and slow the heart rate, and diuretics which increase the flow of urine, reducing the amount of fluid in your body.


Surgeries may include coronary bypass surgery, a pacemaker, heart valve repair, a ventricular assist device, or a heart transplant. The problem with these treatments, other than a heart transplant, is that they are not actually repairing any damage. At best, they minimize symptoms and slow the progression. Scientists have been working for decades to find a treatment that will actually repair the damage and return your heart to health. Stem cell therapy has proven to be one of the most promising options.


If you would like an explanation of the science of stem cells, how donor stem cells work to heal, various types of stem cells, and the benefits of mesenchymal stem cells in particular, you can view this article. It may be helpful in understanding some of the concepts discussed in the next section.


Heart Failure - Temecula Center for Integrative Medicine

Regenerative Medicine Provides Hope for People with Heart Failure


If you are skeptical about this claim, the Mayo Clinic, which is one of the most reputable hospitals in the United States, states that “Clinical studies have shown that stem cells are not only safe, but can be effective treatment options for patients with heart disease.” They stand by this to such an extent that they have poured enormous amounts of money and resources into a Cardiac Regenerative Medicine Program to create next-generation stem cell therapies that will treat heart failure. Many other reputable hospitals and research centers such as Johns Hopkins University, Cedars-Sinai, Stanford University, and the Cleveland Clinic are working with stem cells to find a cure for heart failure.


One interesting study by researchers at the University of Miami found that stem cell therapy using MSC’s reduced scar tissue on the heart muscle, enhanced the heart’s pumping ability, and improved the patient’s quality of life. Scar tissue was reduced even when the damage was done decades before the treatment. The reduction in scar tissue also caused many of the hearts to become a more normal size, which helps the heart pump more effectively. The study also examined the results at three different doses of stem cells: 20 million, 100 million, and 200 million. Strangely, the dose that was most effective was the lowest, 20 million stem cells (2).


Mesenchymal stem cells (MSC’s) were used in this and many other studies because research shows that they are one of the best options for treating heart failure. There are many reasons for this. They reduce inflammation, help regulate the immune system, and stimulate your body’s own stem cells to begin functioning better to replace damaged and old heart tissue. Umbilical cord-derived MSC’s are not recognized by a person’s immune system as being foreign, so they are not rejected and do not need to be matched between the donor and recipient. They are also easily acquired from donors and do not need to be collected from the patient.


Since research is proving that stem cell therapy is safe and effective for treating heart failure, then why is it not widely used? At this point, it is mostly a matter of finding the most effective treatment. Clinical trials are still underway to determine all the factors that increase efficiency. As shown when the University of Miami study discovered that the smaller dose of stem cells was most effective, the results are not always the most obvious choice. Delivery method, type of stem cell used, number of cells used in treatment, whether allogeneic (from a donor) or autologous (from the individual being treated) stem cells are most effective, and many other factors are being studied. Once all these factors are known, then companies will go through the process of gaining FDA approval.


Unfortunately, that does not help people that have already been diagnosed with heart failure and do not meet the requirements to be included in a clinical study. Since stem cell therapy has been proven to have a low risk of side effects, many practitioners have begun using stem cell therapy for conditions that already have shown promising results in current clinical trials, including heart failure. However, it is important to note that while heart failure is being treated with stem cells in many clinical trials, all procedures involving stem cell products are considered experimental and are not yet approved by the FDA for the treatment.


At Temecula Center for Integrative Medicine, we have seen patients with heart failure gain improvement in heart function. If you have been diagnosed with heart failure, we want to help. We treat the whole person, not merely the diagnosis. We won’t just give you medications to manage symptoms but will investigate the causes and try to help you regain health and a better quality of life. After a thorough evaluation, we will develop the best treatment plan specifically tailored to you. Stem cell therapy, along with other regenerative therapies, works to heal by creating functional, living tissue that can replace or repair the existing damaged tissue, and maybe a vital part of your treatment plan.

 

Jonathan Vellinga, M.D. is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.​


Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.

info@tcimedicine.com

951-383-4333


 

1. Mozzafarian D, Benjamin EJ, Go AS, et al. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2016;133:e38-e360.


2. Hare, J. M., Fishman, J. E., Gerstenblith, G., DiFede Velazquez, D. L., Zambrano, J. P., Suncion, V. Y., … Lardo, A. (2012). Comparison of allogeneic vs autologous bone marrow–derived mesenchymal stem cells delivered by transendocardial injection in patients with ischemic cardiomyopathy: the POSEIDON randomized trial. JAMA, 308(22), 2369–2379. doi:10.1001/jama.2012.25321



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