- Cardiomyopathy is a
disease of the heart muscle that can progress to heart failure.
- Current study used autologous skeletal myoblast-sheet
transplant to treat heart failure.
- Preliminary results
appear promising warranting further research in a larger study.
cell sheets derived from the patient's skeletal
muscle in the thigh and grafted onto the heart surface have
shown encouraging results including improved heart function and exercise
tolerance and could be a viable option to treat heart failure,
according to a team of Japanese scientists.
Reason For the Study
‘Cell-sheet transplant as single line treatment for cardiomyopathy shows promise, especially in the face of severe shortage of donor hearts for transplant.
research team feels that existing therapies for heart failure
including medications, pacemaker
implantations or even heart transplants
are not effective or viable longterm options. Rather, they feel that muscle regenerative treatment
using the patient's
own skeletal muscle cells might be a safe and feasible longterm
Methods of the Study
total of 27 patients suffering from
from various causes, were enlisted for this Phase I Clinical
Study. They were found to have heart failure (New York Heart Association
functional class†II†or†III) with reduced heart function and
limited exercise capacity, and had received maximum possible therapy without much
this scenario, the research team transplanted
scaffold free muscle cell sheets derived from the patient's own thigh muscle on
to the surface of the patient's heart by means of a surgical procedure
other interventions were made as part of the treatment.
Findings of the Study
the patients were tracked over the
year following the transplant. The notable findings
included the following.
What is Cardiomyopathy?
- The procedure was safe with no major complications from
the procedure. Specifically no serious heart rhythm disturbances (arrhythmias)
were noted in the patients.
- There was marked improvement in heart function with better exercise capacity including better performance in the Six-Minute
Walk Test which tests exercise
- Levels of B-type
natriuretic peptide (BNP) levels went down. BNP is a hormone secreted by
heart, the levels of which increase in heart
failure and decrease when heart function improves.
ventricular stress decreased and left
ventricular function improved notably.
is a disease of the
heart muscle which affects the ability of the heart to effectively pump blood.
With progression, the patient develops shortness of breath, chest pain,
swelling of legs and feet, and severe limitation of routine activities. With
progression of the disease, the patient goes into heart failure.
treatment involves medications to improve heart function and relieve symptoms,
pacemaker implantation, surgery and in extreme cases a heart transplant.
Limitations Of Other
Stem Cell Therapies in Heart Muscle Regeneration
major advances in stem cell research in the last decade, various cell therapies
have been tried hoping to regenerate heart muscle cells. The notable
observations emerging from stem cell research in relation to heart muscle
regeneration have been the following.
- Cell therapy is a safe, albeit
modestly effective in improving heart function, probably due to certain
chemicals released by these cells that exert a slight local (paracrine) effect
on the heart tissue to improve its function.
- Adult bone
marrow stem cells have only limited capacity to differentiate into heart muscle
- Embryonic stem cells may be a better option but ethical issues surrounding their
use is a major stumbling block in stem cell research.
of future research should involve use of endogenous stem cells that are capable
of differentiating into heart muscle cells.
studies have shown that cell-sheet transplant on to the surface of the heart is
more effective than cell injections in maximizing the paracrine effect exerted
by them to improve heart function.
- Use of scaffolds for
tissue regeneration have been found to be associated with complications such as
inflammatory response, biodegradability and compatibility issues.
experience from previous studies and research, the current study used the patient's
own thigh muscle (endogenous) cells to generate skeletal myoblast cell
Also they transplanted (avoiding injections which were not as effective)
scaffold free cell sheets onto the surface of the patients heart surgically.
conclusion, the results of the current study seem highly encouraging and
justify further follow-up of patients and
conducting larger trials to establish the efficacy of autologous muscle
cell-sheet transplant in the treatment of heart failure due to cardiomyopathy.
- Phase I Clinical Trial of Autologous Stem
Cell-Sheet Transplantation Therapy for Treating Cardiomyopathy -
- Stem cell patch shows early promise in treating
heart failure - (http://newsroom.heart.org/news/stem-cell-patch-shows-early-promise-in-treating-heart-failure?preview=060f)
Natriuretic Peptide (BNP) Blood Test - (https://my.clevelandclinic.org/health/articles/b-type-natriuretic-peptide-bnp-bloodtest)
Skeletal Myoblast Sheet Therapy for Porcine Myocardial Infarction Without
Increasing Risk of Arrhythmia - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733831/)
- Stem Cell Therapy for Heart Failure -
- Treatments and drugs - (http://www.mayoclinic.org/diseases-conditions/cardiomyopathy/basics/treatment/con-20026819)