Stem Cells for Heart Disease: hype or hope Robert M. Graham Victor Chang Cardiac Research Institute and St Vincent’s Hospital, Sydney, Australia Australian Health Insurance Association Conference 31 Oct - 2 Nov, 2006. 1 November, 2006. Cardiology – where have we been?.
Stem Cells for Heart Disease: hype or hopeRobert M. GrahamVictor Chang Cardiac Research Institute andSt Vincent’s Hospital, Sydney, AustraliaAustralian Health Insurance Association Conference31 Oct - 2 Nov, 2006
Earliest known cardiaccatheterisations wereperformed by Hales in1711 – inserting brasspipes through the veinsand arteries into thehearts of horses.
Using the wind-pipes ofgeese as a connector,the brass pipes wereconnected to glass tubesto measure pressure –the water columns roseto >9 feet.
On February 12th 1974,Andreas Gruentzigperformed the first balloon dilation of a human leg artery, and in 1977 this was then done in the human heart.
Prometheus, who was damned to be chained to Mount Caucasus for 30,000 years. Every day an eagle would come down and pick his liver, and the next day it would have regenerated.
The hound of Zeus, the tawny eagle,
…feasting on thy liver
Till he hath gnawn it black.
- Aeschylus, Prometheus Bound
Stem cell and divides
Muscle, skin, vessel
Old way of thinking =
Stem cell trial at St Vincent’s Hospital and The Victor Chang Cardiac Research InstituteGranulocyte-colony stimulating factor (G-CSF) and intra-coronary endothelial progenitor cell (EPC) infusion in patients with chronic refractory ischaemic heart disease
Clinical trial at SVH and VCCRI
VCCRI cardiac stem cell lab
BM after 5 days G-CSF
Body mass index
High blood pressure
Family history (1st degree relative < 55 male or < 65 female)
Number of bypass operations
Number open bypass grafts
Number of open heart arteries
Pumping ability of the heart (LVEF)
Number of cardiac tablets per day
62 ± 9.0 (36 - 74)
Male = 18/20, female = 2/20
29.8 ± 4.4 (22.1 - 39.2)
17/20 ex, 0/20 current
1.6 ± 0.7 (1 - 3)
1.5 ± 1.0 (0 - 4)
0.7 ± 0.9
48.7 ± 10.3% (30 - 65%)
8.7 ± 1.4
Data presented as mean ± SD (range), or number of patients/20
Less chest pain
Less use of medications to get rid of chest pain
Exercise time on the treadmill improved
Quality of life improved
On the basis of this small study of 20 patients,
and with support from MBF, we are already in the
advanced planning stages for a larger study
to do the first human studies