Stories of Hope: Heart Failure

Fred Lesikar - Stories of hope: Heart failure It was grandpa to the rescue when Fred Lesikar‘s granddaughter tried to put on a pair of jeans several sizes too small. The toddler was stuck. She could not pull them up, and she could not pull them off. Lesikar, then 59, stood on the cuffs of the jeans and began to lift her out of the pants.

But it hurt. Pain radiated across his back and around his chest. It ran through his biceps and up under his chin.

He should have called 911. He will tell you that now. Instead, he asked his stepdaughter to drive him to the hospital.

Help came too late to save his heart from permanent damage. He returned home much diminished. Walking around the block felt like a marathon, and he was losing the race.

Today, everything is different. “I’m in better shape than I’ve been in in years,” he says. Some months after his attack, he enrolled in a clinical trial, in which researchers harvested a bit of tissue from his heart, coaxed stem cells from the tissue to grow, and put the cells back into his heart again. The results? Lesikars heart is functioning better and the scar left from his heart attack appears to be reduced.

The study that helped Lesikar led to a more than $19 million disease team award from CIRM to fund a clinical trial for the next generation therapy.

“It’s given me a new life,” Lesikar says. “The process, from the patient’s point of view, is an easy, painless miracle, and I’m very thankful.”

TOWARD A CURE: HEART FAILURE

The heart is a finished canvas. Scar it with a heart attack and the harm is probably irreversible.

Or it was.

Eduardo Marbán, a heart researcher and director of the Cedar-Sinai Heart Institute in Los Angeles, has tested stem cells as a way of treating the scarred hearts of 16 patients enrolled in a clinical trial. While several previous groups have generated some heart function improvements with stem cells taken from the bone marrow, Marbán’s work is among the first to use cells from the heart in an attempt to repair damage caused by a heart attack.

As part of a clinical trial, the subjects were treated with stem cells grown from their own heart tissue. As a result of the treatment, their scars appeared to shrink and they regained some heart function.

Marbán and colleagues at Johns Hopkins recruited patients with recent heart attack damage and collected a small biopsy of heart tissue through a 15-minute catheterization procedure. This smidgen of tissue was put into a lab dish, where it formed little spheres called cardiospheres “chalk full of stemness factors, ” Marbán says. Finally, cells taken from the spheres were infused back into the patient’s heart via a catheter threaded to where the original damage began. These cells could not be detected several weeks later, suggesting that the benefits came from factors delivered to the damaged tissue rather than from the cells incorporating into the heart.

While Marbán’s group prepares to offer these cardiosphere-derived stem cells to hundreds of patients in planned phase 2 trials, this time from donors rather than the patient, he sees a perhaps more dramatic role for the cardiospheres themselves in patients with severe heart failure. That goal is the basis of a $5 million CIRM-funded disease team award to Marbán.

In mouse studies, he noted that the cardiospheres performed even better than the cells derived from them.

“We believe that if we’re going to pull out all the stops and help the most desperately ill patients who otherwise would go onto machines or have transplants, or to die, this is what we would want to give them.”

Marbán tells the story of being approached by one of the stem cell trial participants while he was out with his family.

“I feel like a new man,” the patient told him.

“How often does this happen, that you have an idea and it turns into something that helps people?” Marbán muses. “It’s a heady experience.”