RESEARCH PROJECTS

It has recently been discovered that there is a circulating group of cells in human beings that can help repair the heart when it is damaged. This was first realised when a woman's heart was transplanted into a man, and having failed, had to be removed after a year. Examination of the heart under the microscope showed that some of the cells in the woman's heart had a Y-chromosome in the nucleus.
A Y-chromosome is only found in male cells and, therefore, these cells must have come from the blood of the man who received the woman's heart.

Stem cells that can repair the heart come from the bone marrow. Studies were, therefore, performed to show that it was safe to put concentrated bone marrow cells into a human heart at the time of heart attack. We are now going to perform a definitive study of the use of concentrated bone marrow stem cells transplanted into the heart very shortly after heart attack has occurred.

Although we can treat, to some extent, the cause of heart attack by dissolving a clot in the artery taking blood to the heart muscle by using a clot busting drug, there is a need for treatments to alter the effects of heart attack on the heart muscle. The muscle is partly destroyed and this leads to heart failure. We have evidence from experience in the rat that bone marrow transplanted cells early after heart attack can have a dramatic effect on the heart so that damage is reduced to a minimum.

Patients who come to St Bartholomew's/The London or University College hospitals in London with a heart attack will be asked to give their permission to enter the study. After they have received all the normal treatment for heart attack, those consenting to the study will have a small amount of their bone marrow taken under local anaesthetic and inserted through a small tube into an artery in the heart that supplies the area of potential damage in the heart muscle. Half the patients will receive bone marrow, the other half will not. This is called a controlled trial and the collaboration of the patients is essential if we are to understand whether stem cell repair of the heart is a new treatment for heart attack. The study will take two years.

John Martin
Professor of Cardiovascular Medicine
University College London