Treatment of heart failure: ultrasound + cell therapy
Experimental therapy tested by specialists of Goethe University in Frankfurt, consisting of pretreatment of the heart tissue with a shock ultrasound wave and subsequent administration of mononuclear cells isolated from the bone marrow, provided a significant, albeit moderate, increase in the left ventricular ejection fraction in patients with chronic post-infarction heart failure.
In recent years, various groups of researchers have published data according to which the introduction of stem cells isolated from bone marrow, heart tissue and adipose tissue contributes to the restoration of heart function after myocardial infarction. The results of a recent meta-analysis indicate that the introduction of a fraction of bone marrow mononuclear cells (which includes stem cells) into the post-infarction injury zone also provides a moderate but stable improvement in the functioning of the ventricles of the heart and improves the condition of patients.
The authors decided to try to increase the effectiveness of this therapeutic approach by combining it with the impact of an ultrasound shock wave on the heart tissue. As shown by earlier experiments, this procedure stimulates the synthesis of homing factors in the treated tissue, which contribute to the retention of more injected stem cells.
103 patients with chronic postinfarction heart failure participated in a randomized placebo-controlled clinical trial conducted in the period from 2006 to 2011. They were randomly divided into three groups, one of which was subjected to low–dose ultrasound (n=42), the second to high-dose ultrasound (n=40), and the third acted as a control group (n=21). A shock wave of ultrasound was applied to the anterior wall of the left ventricle of the patients' heart.
After 24 hours, the patients who underwent preliminary ultrasound exposure were randomly divided into 2 groups. One group of patients had their own bone marrow mononuclear cells injected into the coronary artery, and the second group received a placebo. All patients who were subjected to fictitious ultrasound were injected with their own bone marrow mononuclear cells.
An examination conducted 4 months after the therapy showed that the left ventricular ejection fraction in patients who underwent preliminary ultrasound exposure and bone marrow cell injection increased by 3.2%. For the group exposed to ultrasound and placebo administration, this figure was 1%. At the same time, the thickening of the ventricular wall (by 3.6%) occurred only in patients of the group who received complex therapy.
The results obtained indicate that the impact of an ultrasonic shock wave increases the effectiveness of the introduction of bone marrow mononuclear cells in the treatment of post-infarction heart failure. However, the results obtained require confirmation in larger clinical trials.
Article by Birgit Assmus et al. Effect of Shock Wave–Facilitated Intracoronary Cell Therapy on LVEF in Patients With Chronic Heart Failure. The CELLWAVE Randomized Clinical Trial is published in the Journal of the American Medical Association.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru Based on Medical News Today: Treatment For Heart Failure Involving Cell Therapy, High-Dose Ultrasound Results In Modest Improvement In Measure Of Cardiac Function.
19.04.2013