Heart disease is the number one cause of death for men and women in the U.S., causing about 600,000 deaths annually – or about one out of every four deaths that occur each year. Nearly 740,000 people have heart attacks each year, including more than half a million people who have never had a heart attack in the past. [1]

More than half of heart disease-related deaths are due to coronary heart disease, the most common type of heart disease. Coronary heart disease occurs when the arteries that supply blood to the heart (the coronary arteries) become narrowed by a buildup of a waxy substance called plaque. This condition is called atherosclerosis, or often, “hardening” of the arteries.

Several risk factors contribute to the development of heart disease, including:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Sedentary lifestyle
  • Poor diet
  • Alcohol abuse

Other types of heart disease include congenital heart disease (from birth); valve disease; arrhythmia; atrial fibrillation; heart muscle disease; pericarditis; and congestive heart failure. [2]

WHAT ARE THE SYMPTOMS?

The symptoms of heart disease can vary based on the type of disease, but some of the most common symptoms include [2]

  • Shortness of breath
  • Fatigue
  • Dizziness
  • Irregular heartbeat
  • Angina
  • Nausea
  • Profuse sweating
  • Palpitations
  • Swelling in the hands or feet
  • Discomfort in the chest, including a feeling of heaviness or tightness

For coronary artery disease, one of the most common symptoms is angina, a type of chest pain that can be mistaken for heartburn. Angina can cause sharp pain, feelings of heaviness on the chest, squeezing or burning sensations or a feeling of increased pressure. These symptoms can also occur in the neck, jaw, shoulders, back or arms.

TRADITIONAL MANAGEMENT

Heart disease treatment relies on a combination of approaches, including medication and lifestyle changes. The primary aims of treatment are to stabilize the condition and improve its symptoms.

Medications typically used to combat heart disease include [3]

  • Blood pressure medications like beta blockers and calcium channel blockers
  • Cholesterol medications
  • Vasodilators
  • Anticoagulants
  • Diuretics
  • ACE inhibitors
  • Antiplatelet medications
  • Digitalis

Lifestyle changes are a critical part of maintaining good heart health and preventing or slowing disease progression. Some of the most common lifestyle recommendations include:

  • Quitting smoking
  • Adopting a low-fat, low-sodium, high-fiber diet
  • Being physically active
  • Reducing stress and anxiety

Lifestyle changes can also help reduce blood pressure and cholesterol levels.

When medication and lifestyle changes aren’t enough, surgeries including angioplasty with stenting, cardiac bypass, cardiac ablation, valve replacement or other approaches may be recommended, depending on the type of heart disease.

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STEM CELL THERAPY FOR HEART DISEASE

Most heart disease involves some sort of damage or irregularity to the heart muscle or structure. Damage can be caused by the disease, such as coronary heart disease and heart attacks, or the disease can arise because of an anomaly of the heart structure, such as in a valve. While some tissue, such as skin, has the ability to regenerate and repair itself throughout life, other cells such as heart cells (or cardiomyocytes) have limited ability to change. As a result, when damage to the heart occurs as a result of cardiac disease, that damage can cause lifelong functional impairment and even make the heart more prone to further disease.

Because of their ability to differentiate into multiple types of cells including cardiomyocytes, mesenchymal stem cells (stem cells derived from adult tissue) have been widely studied for the management of different types of heart disease. Mesenchymal stem cells also work through a method of cell-to-cell communication called paracrine signaling, triggering local cells to remodel or repair. A third mechanism stimulates the development of new blood vessels (neovascularization) that support the development of healthy cells and healthy cell function. Several studies have examined these mechanisms in relation to different types of heart disease and their effects on heart function, and even on the ability of the heart to heal itself. [4][5]

One of the most prevalent effects of heart disease and heart attack is the death of heart cells caused by a decline in the amount of oxygen-rich blood. The painful symptoms of angina and heart attack are both related to the heart’s inability to get the blood it needs to continue to function. The death of heart tissue cells causes scar tissue formation which can make the heart less elastic and less able to pump efficiently.

Several stem cell studies have demonstrated the ability of these cells to form into cardiomyocytes. [6] For instance, in one recent study, researchers found engrafted mesenchymal stem cells improved the function of the heart’s left ventricle (the portion of the heart responsible for pumping blood out of the heart, through the aorta and into the body), decreased scar size and induced remodeling of injured tissue. [7] Other research has focused on the use of stem cells for heart valve repair, specifically in combination with a “scaffold” to support growth of new valves outside of the body for future implantation. [8]

Heart disease does not have to be debilitating.

Suggested Reading:

  1. Heart disease facts. Centers for Disease Control and Prevention. 2014. Available at: Center for Disease Control.
  2. Heart disease symptoms & signs. WebMD. Available at: WebMD.com.
  3. Cardiac medications. American Heart Association. Available at: Heart.org
  4. Boyle, AJ. Controversies in Cardiovascular Medicine: Ready for the Next Step. Circulation. 2006;114(4):339-352. doi:10.1161/CIRCULATIONAHA.105.590653.
  5. Premal Trivedi, Nancy Tray, Thuy Nguyen, Neha Nigam, and G. Ian Gallicano. Stem Cells and Development. July 2010, 19(7): 1109-1120. doi:10.1089/scd.2009.0465.
  6. Minguell, J.J. Mesenchymal stem cells and the treatment of cardiac disease. National Center for Biotechnology Information. 2006. Available at: National Center for Biotechnology Information.
  7. Gnecchi, M, Danieli, P, Cervio, E. Mesenchymal stem cell therapy for heart disease. Vascular Pharmacology. 2012;57(1):48-55. doi:10.1016/j.vph.2012.04.002.
  8. Badylak, SF. Regenerative Medicine Approach to Heart Valve Replacement. Circulation. 2005;111(21):2715-2716. doi:10.1161/CIRCULATIONAHA.105.542837.

Mesenchymal stem cell-derived exosomes: A novel potential therapeutic avenue for cardiac regeneration.

Safari S, Malekvandfard F, Babashah S, Alizadehasl A, Sadeghizadeh M, Motavaf M.

Cell Mol Biol (Noisy-le-grand). 2016 Jun 30;62(7):66-73. Review.

Cellular Therapy for Heart Failure.

Psaltis PJ, Schwarz N, Toledo-Flores D, Nicholls SJ.

Curr Cardiol Rev. 2016;12(3):195-215. Review.

Mesenchymal stem cells in cardiac regeneration: a detailed progress report of the last 6 years (2010-2015).

Singh A, Singh A, Sen D.

Stem Cell Res Ther. 2016 Jun 4;7(1):82. doi: 10.1186/s13287-016-0341-0. Review.

From Bone Marrow to Cardiac Atrial Appendage Stem Cells for Cardiac Repair: A Review.

Hendrikx M, Fanton Y, Willems L, Daniels A, Declercq J, Windmolders S, Hensen K, Koninckx R, Jamaer L, Dubois J, Dilling-Boer D, Vandekerkhof J, Hendrikx F, Bijnens E, Heuts N, Robic B, Bito V, Ameloot M, Steels P, Rummens JL.

Curr Med Chem. 2016;23(23):2421-38. Review.

Intramyocardial transplantation of mesenchymal stromal cells for chronic myocardial ischemia and impaired left ventricular function: Results of the MESAMI 1 pilot trial.

Guijarro D, Lebrin M, Lairez O, Bourin P, Piriou N, Pozzo J, Lande G, Berry M, Le Tourneau T, Cussac D, Sensebe L, Gross F, Lamirault G, Huynh A, Manrique A, Ruidavet JB, Elbaz M, Trochu JN, Parini A, Kramer S, Galinier M, Lemarchand P, Roncalli J.

Int J Cardiol. 2016 Apr 15;209:258-65. doi: 10.1016/j.ijcard.2016.02.016

Stem cell-based therapies to promote angiogenesis in ischemic cardiovascular disease.

Hou L, Kim JJ, Woo YJ, Huang NF.

Am J Physiol Heart Circ Physiol. 2016 Feb 15;310(4):H455-65. doi: 10.1152/ajpheart.00726.2015. Review

Myocardial infarction: stem cell transplantation for cardiac regeneration.

Carvalho E, Verma P, Hourigan K, Banerjee R.

Regen Med. 2015 Nov;10(8):1025-43. doi: 10.2217/rme.15.63. Review.