thoughts on cellular cardiomyoplasty?

[PoetMD]

I was doing some research on-line about this exciting area of research and wanted to know what you all think about this as a potential curative therapy for heart failure pts etc etc - the use of stem cells and/or autologous skeletal myocytes to replace ischemic myocardium. How far are we from this as a commmonplace intervention for post-MI and heart failure patients? Is anyone here actively involved in this type of research?

Also- do you all think that this will be the type of thing Interv Cards will eventually handle or will it be in the domain of CT surgery? Or maybe both? Seems that if you could prove the safety and efficacy of the percutaneous transvascular route and be able to implement it routinely at medical centers around the country this would be HUGE!! How far is this from reality? Maybe sooner than we think if Obama keeps his word about supporting stem cell research....

Also- last question- how would someone like me- an MD-to-be in 2010 start getting involved in this type of research? Go for ABIM research track or take time off to just focus on research?

Sorry for the long post and all the questions...know you all are very busy. Thanks for any info you can share.

Best,
PoetMD

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[astropilot]

Its funny you ask a question like this. You should check out this link. The Chief of Cardiology, Bolli, and Chief of CT surgery, Slaughter, of the University of Louisville and Anversa from BWH are actually trying this out very soon.

As for getting into this, at this time in your training, you should either take time off to learn basic science techniques (maybe all of your elective time during 4th year) or just do clinical. Its not impossible, but a lot of PIs look for 1) who has an expertise in an area, 2) can broaden their area of interest, 3) someone who is really committed to research if they are going to invest in that person time and money. You might be able to find a little project, but don't plan on being able to go 100% in stem cells after cards fellowship without doing a separate fellowship in research first.

As for who will do this, I think both CT Sx and Interventionalist will do this, but Cardiologist with push this.

 

[Firebird]

I was doing some research on-line about this exciting area of research and wanted to know what you all think about this as a potential curative therapy for heart failure pts etc etc - the use of stem cells and/or autologous skeletal myocytes to replace ischemic myocardium. How far are we from this as a commmonplace intervention for post-MI and heart failure patients? Is anyone here actively involved in this type of research?

Also- do you all think that this will be the type of thing Interv Cards will eventually handle or will it be in the domain of CT surgery? Or maybe both? Seems that if you could prove the safety and efficacy of the percutaneous transvascular route and be able to implement it routinely at medical centers around the country this would be HUGE!! How far is this from reality? Maybe sooner than we think if Obama keeps his word about supporting stem cell research....

Also- last question- how would someone like me- an MD-to-be in 2010 start getting involved in this type of research? Go for ABIM research track or take time off to just focus on research?

Sorry for the long post and all the questions...know you all are very busy. Thanks for any info you can share.

Best,
PoetMD

This was the subject of this AM's grand rounds. The presenter stated he believes that in 20-30 years, this will be a viable intervention. His point was that there is vast amounts of research that must take place, such as growth factor interaction, delivery, etc., before it can leave clinical trials.

The current techniques seem to employ catheter delivery systems through the coronaries. If this continues to be the preferred method of delivery, I suspect interventional cardiology will grab this procedure and bill the heck out of it.

However, there was also discussion of growing myocardial laminates in vitro and adhering them to existing muscle. This would obviously require a CT surgeon.