I had to share this with anyone reading the cardiac subforum. This is an excerpt from, "Cell of Cells" by Cynthia Fox. I have given you a little information beforehand to catch you up with what Ms. Fox is writing about.
Emerson Perin is a cardiologist based at the Texas Heart Institute. He began to use NOGA, an electromagnetical mapping system in Rio de Janeiro where he once lived and had a partnership with a hospital. This metallic sensor - tracked via magnets above and below patients - was giving doctors a stunningly clear view of the heart during therapeutic procedures. He had plans to use NOGA to inject healing growth factors into hearts, but learned at a 2000 European meeting that some scientists were shooting bone marrow stem cells through animal coronary arteries and this made him wonder. He knew that stem cells are growth-factor factories which was perfect for what he wanted to do. He also wondered if when stem cells were slipped into blood if they would further clog arteries. Some studies seemed to indicate that and that more scar could be created when added to scar. He decided that it might be best to inject them right into heart muscle and only hard-to-see, scar-free muscle.
He chose Rio for his first test, not the U.S. (Does this surprise anyone?). Some basic scientists believed the cells created only blood and blood vessels; some believed they only emitted growth factors; many, including some scientists at the U.S. FDA, believed they shouldn't be used on patients until they were completely understood. (That should be in the year 3000).
Direct excerpts from the book -
Yet, says Perin, basic scientists "don't have to face dying patients". I do Every day I have to look heart patients in the eye and tell then I can't help." So he chose to do his first trial outside the U.S. maelstrom - in Rio, where NOGA was reading - confident that for end-stage patients without options he was doing the right thing.
Still he was aware of the risks. One of the first patients the Rio hospital offered him almost gave Perin himself a heart attack. "He was ashen, unable to breathe, and cachetic (starving) because you can't eat if you can't breathe. His ejection fraction (left heart pumping ability) was 10-any less than that and you're dead. (Normal is 55.) I thought he was going to die. I called the doctor in charge and said, "This guy isn't even able to lie flat. I'll go ahead and do a map on him, and if I find an area of viability maybe we'll think about it," Perin says. "Well, I found a little area in the back that showed viability. So I called the doctor again and said, 'Should we do this?' I was really worried." Given the controversy surrounding stem cells, a single death could end the whole trial.
Persuaded eventually by the notion that the sickest patients stand to gain the most, "I took a deep breath, injected the guy, and went back to Texas. When I came back 3 months later to inject some more patients, the one who was so gray? He was tan and smiling. One month after that, he was jogging on the beach. That's when I called the improvement we started to see, 'the tanning factor.' And that's when I thought, "This is no placebo effect."