Many different factors and conditions can cause CD including:
Coronary artery disease
Acute MI
Post myocardial infarction akinetic ischemic myocardium
Dilated cardiomyopathy
Congestive Heart failure
Diabetes
High blood pressure
Obesity
Patients with whatever the aetiology have an irreversible loss of cardiac tissue and ultimately have a significantly decreased left ventricular function. The myocardium does indeed have a limited regenerative capacity.
Stem cells from bone marrow or adipose tissue injected into areas of low perfusion or scars in the cardiac tissue may become populated with angiogenic stem cells, improving blood supply in the area and reducing myocardial scar size.
The benefits are postulated to come from their influence on neovascularization of the ischemic tissue and their protection of resident cells. The paracrine and secretion of various angiogenic and survival growth factors further enhance the recovery of injured myocardium.
The procedure significantly improves left ventricular cardiac function and decreases mortality.
How It Is Done
Thegoalis to transplant within the cells in infracted, ischemic, hypo contractile myocardium directly or indirectly.
In Acute MI it is done with 3 to 7 days
The possible routes are:
Intracoronary Transplantation: Cells can be administered into the coronary artery just like a dye as in routine angiographic procedures. The cells get distributed into whole of the myocardium through branches of coronary artery.
Intramyocardially through catheter
The cells can also be administered intra-myocardial into the targeted treatment region using the special catheter delivery system under fluoroscopic guidance.
What To Expect
80% patients reach close to Six-minute walk test (6MWT) of >400 meters
70% patients achieve a Minnesota Living with Heart Failure (MLWHF) score of <20
74% of patients achieve Left ventricular ejection fraction in mean of 45 at 6 months
75% Reach (NYHA) Class II from pre-treatment IV
50% of patients have improvement in B-type natriuretic peptide (BNP) or NT pro-BNP.
60% had good reduction in Ascites
60% of patients report improvement in Myocardial wall thickness to > 10 mm at the injected site.