Cardiovascular disease (CVD) refers to a broad range of diseases that affect the cardiovascular system, which includes the heart and blood vessels. CVD is the highest cause of mortality in the world and is generally comprise medical conditions involving the narrowing or occluding (blocked) of blood vessels which can lead to a heart attack commonly called an acute myocardial infarction, regular chest pain commonly called angina, peripheral vascular disease, or stroke. One in three deaths globally is attributed to cardiovascular disease, so the impact on our society and economy is staggering. Despite advances in medical and surgical therapies, heart disease remains a major cause of morbidity and death. The American Heart Association estimates that 80 million American adults have CVD in one form or another including heart disease and or peripheral vascular disease.
Cardiac diseases or diseases specifically effecting the heart account for 60% of all the cardiovascular disease, and is the single largest contributor to death. The causes for cardiac disease are numerous, but there is a high correlation to cholesterol levels, smoking, genetic predisposition, and life style effects from diet and exercise. Early modification or intervention of these risk factors is important to avoid a devastating heart attack, which results when a blood vessel in the heart becomes blocked and starves the heart muscle of necessary oxygen
The current aims of modern cardiovascular disease therapies are to reduce the risk of a life threatening occlusion(s) in the body’s vascular network. Should an occlusion develop immediate medical intervention with either pharmaceutical or surgical reperfusion is necessary through anti-thrombotic therapy, stenting or bypass surgery.
ACUTE MYOCARDIAL INFARCTION
When a blood vessel in the heart is occluded, the heart muscle is deprived of oxygen ultimately resulting in heart muscle cellular death. After the initial injury happens from the oxygen deprivation, inflammation follows, cells die and finally a scar replaces dead cellular area where the healthy contractile muscle tissue had been. This scar tissue area is non-functional in that it does not contract, but does help physically stabilize the heart wall itself.
Early medical intervention in this biological process is critical. There is a direct correlation to the timing of medical intervention and the occlusion location within the heart to mortality and morbidity. Approximately 80% of all patients having early medical intervention survive an initial heart attack, but close to half of these survivors will become disabled with heart failure in the next five years. Assuming the heart attack patient survives the event, the doctors will usually assess the probability of recovery and ensuing life style impact through a multitude of factors. However, the single most important factor to predicting long term mortality (death) and morbidity (illness related factors) is the measurement of the hearts ejection fraction or pumping capability. A healthy adult will usually have an EF measurement value between 55-60% as assessed by an echocardiogram (sound waves) or MRI (magnetic resonance image).
The aim of medical standard of care today is to preserve the ejection fraction of the heart, but statistics show that patients who have an ejection fraction below 35% five days post heart attack have a greater then 50% chance of dying from heart failure in the next five years.
The goal of experimental therapies, and specifically stem cell therapy, is to stabilize or reverse the declining ejection fraction of the AMI patient.
PERIPHERAL VASCULAR DISEASE
(PAD) is a form of cardiovascular disease which specifically effects the limbs. Critical limb ischemia (CLI) is a severe type of peripheral arterial disease that results from markedly reduced blood flow to the legs, feet and hands. It is estimated that more than 15 million people suffer with PAD globally, and 4-5 million people with CLI. Early standard of care includes drug therapy to reduce the risk of embolism formation, typically anti-platelet drugs, cholesterol lowering therapy to reduce disease progression, and life style changes including diet and exercise.
Some patients may have severe disease requiring vessel bypass surgery or the implantation of vessel mechanical stents.
Failure of any of the above treatments usually results in open leg ulcers or tissue necrosis, and if blood flow is not restored typically progresses to surgical amputation of some or all of the effected limb.
Cesca SurgWerks® Cardiovascular Development
Critical Limb Ischemia (see Clinical Pipeline)
Acute Myocardial Infarction (see Clinical Pipeline)