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Growing new heart muscles

CELL transplantation to promote growth of new heart muscles was first done in the United States in 2002, 16 years ago, through cardiac catheterization as a standalone treatment for heart failure secondary to scarred heart muscles due to a heart attack. This was performed during coronary bypass surgery or among patients with Left Ventricular Assist Device (LVAD), which is a machine that helps the failing heart to heal and pump better.

Cardiac catheterization is a minimally invasive procedure that is used to inject dye into the coronary arteries to diagnose blockages in the coronary arteries. Using the same simple technique, cardiologists recently transplanted muscle cells from the thigh by injecting them into the heart’s scar tissues. The transplanted cells regenerated part of the scarred (non-contractile) heart muscles, resulting in new heart muscles tissue formation, improving the contractile function of the heart muscles.

The study, conducted in five patients who had severe heart failure following heart attack, was published in the December 17, 2003 issue of the Journal of the American College of Cardiology, and still pertinent and relevant today.

Heart attack occurs when the heart muscles are deprived of blood (which is the source of oxygen and nutrition), due to blockages of the coronary arteries caused by arteriosclerosis (hardening of the artery). This condition results from high serum cholesterol levels, especially abnormally high levels of the Low Density Lipoprotein (LDL, the bad cholesterol) and abnormally low levels of the High Density Lipoprotein (HDL, the good cholesterol).

When the heart muscles suffer from lack of oxygen and nutrition, the muscles die and become scarred tissues, losing their ability to perform its normal function of contracting effectively to eject blood out of the ventricles of the heart to circulate all over the body.

The heart muscles have an insignificant ability to repair itself, and when so affected by a heart attack, the heart muscles become weak, then scarred, and ineffective in its pumping ability, and heart failure ensues.

The cell transplantation procedure included harvesting the donor muscles (in these cases, the thigh muscles), and loading them in a catheter, which was threaded through the heart vessels (coronary arteries), much like a diagnostic cardiac catheterization or angioplasty, and injected into the scarred muscles of the heart. These cells grow and generate muscle “production” which become part of the heart muscles, enabling them to regain their effective contractility.

Patients who had the cell transplantation done had improved left ventricular ejection fraction (LVEF), which is a measure of the heart’s ability to pump effectively and eject oxygen and nutrition-rich blood into the circulation.

While the preliminary study is exciting and shows promise, more extensive studies by different heart centers and investigators are in progress.

Drug abuse
Some users call it DXM, others, Dex, for dextromethorphan. This is an ingredient in very popular over-the-counter cough and cold remedies, about 125 of them. Other medications have been nicknamed Robo” for Robitussin and CCC for Coricidin, cough and Cold tablets. Other names “Candy,” “Red Devils,” and “Skittles.”

According to the statistics of the United States government, generations of teenagers have consumed the cough suppressant dextromethorphan (DXM) to get high, and about two thousand of these users ended up in emergency rooms all over the country each year. In 2002, it was 2311. In the 1970s, DXM replaced codeine, a powerful cough suppressant and pain killer. Since then, DXM has been abused, especially by young people. National Institute of Drug Abuse (NIDA), in its 2017 surgery showed “the rates of alcohol and tobacco use by the nation’s youth are declining, but an increase in lysergic acid diethylamide (LSD) use in high school seniors was evident.”

Heart failure and cholesterol
Medical science and technology are a most dynamic duo. A new study published the Journal of American Cardiology
indicated that heart failure patients may benefit from higher cholesterol level. While a cholesterol level of 150 mg/dl is the healthy target for the rest of us to achieve (often times with great difficulty for many of us), patients with heart failure with higher cholesterol level appeared to have a 25 percent greater survival rate for each mmol/l (roughly 232 mg/dl) when compared to those heart failure patients with lower cholesterol. This is something new, and the exact rationale still eludes researchers. They
hypothesize lipoproteins (which are fats contained in cholesterol) “absorb potentially harmful bacteria that can be dangerous to heart failure patients.”

Investigators warned against concluding that low cholesterol increases the mortality rate among heart failure patients. Further studies on more subjects are required to support this preliminary finding before a valid and final scientific conclusion could be drawn. One word of caution: this study pertains only to patients with heart failure. For the rest of us, those lucky ones without heart disease and heart failure, the recommended level of cholesterol is still no higher than 150, if we are to prevent heart attack and stroke.

Green tea
Soft drinks, cola or uncola, regular or diet, flavored or not, are all toxic to the body, for adults and especially for children. They increase the risk for Metabolic Syndrome. Millions around the world have stopped drinking soft drinks. Coffee is healthy but tea appears to take the lead as the healthiest beverage. Tea, in general, especially green tea, a potent antioxidant that protects the body from damaging free radicals, is the best, as we have written about in this column 15 years ago. Indeed, the best is tea, the drink of choice for more than 5000 years in Asia, for its great overall beneficial health effects for our heart and general well-being.

The general recommendation for daily fluid intake of 8 to 10 glasses should include filtered, clean, good old-fashioned water. For breakfast and snack time beverage green tea is great, as it helps in food digestion also. Let’s drink to health. Cheers!

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