Mending Broken Hearts May Soon Be A Reality

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People with broken hearts -- truly broken hearts, those damaged by heart attacks and other injuries -- may soon see a way to have them healed.

Once damaged, a heart cannot heal or be repaired, it cannot grow new tissue.

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The myoblast procedure performed at the Arizona Heart Institute puts new muscle cells into the scarred tissue where it mimics heart muscle, repairing the damage.

Much can be done to keep a damaged heart functioning, such as grafting new arteries to restore blood flow to the remaining healthy tissue of the heart, pacemakers can restore proper rhythm and there are transplants. But there are only 2,000 donor hearts available for transplants, and 1.5 million people in the U.S. have heart attacks each year. Another 2 million have congestive heart failure.

An experimental treatment, called myoblast transplantation, may change the outlook for these 3.5 million Americans, and others suffering similar ailments around the world.

George Sturgis and Robert River, both of Payson, are participants in the experimental procedure being tested by the Arizona Heart Institute and Hospital.

Sturgis, 56, had the procedure in March 2002, along with a triple bypass. "He had had a number of heart attacks and diabetes and his doctors gave him only two months to live," said Marisa Maggio-Harelson of AHI. "Only 26 percent of his heart was working."

Myoblast transplantation uses cells from a patient's thigh muscle, cultures them into millions of new cells, then these are injected into the damaged area of the heart, Maggio-Harelson said. The cells then take on characteristics of new cardiac-like muscle cells in a matter of weeks.

Maggio-Harelson said since the cells are from the patient's own body, there is little chance of rejection.

The cells from the thigh, skeletal muscle, unlike the heart muscle, can repair itself, she explained. The overall goal of myoblast is to improve the heart's ability to contract and pump blood to the body.

She said tests show signs of rejuvenation in Sturgis' heart.

Sturgis found out about the procedure when he went to the Payson Regional Medical Center emergency room, thinking he had the flu.

"I was having trouble breathing," Sturgis said. "They put me in a bed and gave me Nitro."

His doctor had him take some tests, including a stress test on a treadmill, to see if they could pinpoint the problem. Sturgis was then referred to Dr. Robert Rimmer, with the Payson office of AHI.

Rimmer did more tests, Sturgis said, and sent him to AHI in Phoenix for an angioplasty.

"They monitored it with dye and told me all the major arteries were blocked, except for a couple of spider veins," Sturgis said. "I had no idea I'd had a heart attack. I was scheduled for a bypass and while I was waiting I learned they were looking for volunteers for the myoblast."

He and his family reviewed the papers they were given about the procedure and agreed to participate.

The procedure begins with a biopsy of muscle cells from the patient's thigh. A marble-size section of the muscle is removed while the patient is under local anesthesia. The section of muscle is then isolated and expanded in culture in a special cell laboratory for approximately three weeks. The multiplied cells are then injected with a needle and syringe directly into areas of the heart muscle that have suffered past damage from heart attacks and coronary artery disease. The injection/transplant follows a standard coronary artery bypass surgery.

"My surgery was March 13, 2002. They took muscle from my left leg to grow the culture. It went real well. The day of the surgery, after I was out, one of the male nurses asked if I felt like taking a walk. I felt really good. We took a walk around the interior of the building. Usually they only let you go around once. But when they asked how I was doing, I felt good enough that they let me take a second lap."

Only five days after the surgery and myoblast transplant, Sturgis was allowed to go home.

"Before, they said only about 26 percent of my heart was working. Now more than 50 percent of it is good. It repaired itself."

River, 47, also is doing well since the treatment, according to Maggio-Harelson. A trucker by profession, River could not be reached for comments about his experience with th procedure.

At one of his check-ups, they discovered Sturgis had an irregular heartbeat, so he spent another eight days in the hospital and was given a defibrillator implant.

"I've had no recurrence (of an irregular heart beat), but at my last check-up it showed my heart had once had a skip," he said.

Sturgis was a salesman for 33 years, but has since quit that work and has turned to home improvement. He is currently building an addition to his home.

"I get better every day," Sturgis said. "I'm doing a lot of physical stuff I never did before."

Dr. Nabil Dib, chief of cardiovascular research at the AHI, is one of the founders of the new therapy, Maggio-Harelson said. A number of other doctors, around the world, are also testing the procedure.

"The trial shows myoblast is safe. Chances are very good this will be a therapy in the near future, within three to five years," Dib said. It will more likely be five years before it becomes a common treatment, he said, and that depends on finding funding. The cost is about $70,000 per patient, Dib said. An application has been made to the National Health Institute for funding the work, but it was turned down, he said.

Dib also expects the development of an internally placed catheter to deliver myoblast directly to the heart, as opposed to delivering cells through open chest surgery.

"The burden of congestive heart failure is a big issue," Dib said, explaining how the procedure was developed.

"We know skeletal muscles regenerate themselves," he said. "Myoblasts originate from stem cells, but they are predetermined to be muscle. In fact skeletal muscle cells exist in the heart before birth, but afterward disappear."

Dib said the procedure was tried with people awaiting transplants. After the transplant the treated heart was studied and showed the myoblast transplanted cells survived and made muscle.

"It has been done in 22 bypass surgeries. Using positron emission tomography (to monitor) we can differentiate between the living and scar tissue in the heart. We do a baseline scan and another after the procedure and can see it is working."

The myoblast program, along with other developments in treating heart ailments will be featured at the 17th Annual International Congress on Endovascular Interventions Feb. 8 through Feb. 12 at The Phoenician in Scottsdale. More than 1,000 physicians, researchers and technicians from around the world will present and discuss the latest research, treatments and breakthroughs.

As part of the event, the public is invited to watch the latest non-invasive treatments on actual patients live via satellite from the AHI. Dr. Ted Diethrich, the founder of AHI, will demonstrate the use of new technologies and then answer the public's questions. This forum is at 7 p.m. Tuesday, Feb. 10 at The Phoenician, 6000 E. Camelback Road in Scottsdale. Reservations are required as seating is limited and starts at 6 p.m., no admission is charged. To make reservations call (800) 345-4278.

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