Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

 Congestive heart failure (CHF) is a serious and life-threatening illness that is associated with premature death. If one thinks of the heart as a pump, progressive damage to this pump's muscle fibers results in decreased "pump efficiency," which causes blood to, essentially, back-up within the vascular system under increased pressure. This increased back-pressure causes swelling of the entire body (edema), and particularly the lower extremities, the lungs, the liver, as well as within the heart itself. In more severe cases, CHF is associated with generalized weakness and profound shortness of breath.

 

As our population continues to grow older, on average, the incidence of CHF is expected to continue to rise. Although precise estimates are difficult to arrive at, the cost of caring for CHF is thought to be at least $33 billion per year in the United States alone.

 

There are several known major risk factors for CHF, including coronary artery disease and heart attack (myocardial infarction), uncontrolled high blood pressure (hypertension), diabetes, obesity, diseased heart valves, elevated cholesterol, and smoking. In most countries, coronary artery disease and myocardial infarction are the leading causes of CHF, and these two related risk factors account for approximately two-thirds of all CHF cases in the United States.

 

In adults, heart muscle fibers (cardiac myocytes) that have become damaged by chronic oxygen deprivation (myocardial ischemia) or oxygen loss (myocardial infarction) are essentially unable to regenerate themselves, and are gradually replaced by scar tissue that interferes with the heart's pumping action. At the present time, the standard clinical management of heart injury due to ischemia or infarction includes the use of medications such as aspirin, ACE inhibitors, aldosterone antagonists, beta-blockers and nitrates. So-called "reperfusion strategies," including coronary artery stent placement and coronary artery bypass graft (CABG) surgery may also be required in some patients. However, once the heart's blood-pumping muscle fibers have become extensively replaced with non-contractile scar tissue (fibrosis), irreversible CHF develops, and only symptomatic management is possible at this point.

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