Cristiano de Oliveira Cardoso

Congestive heart failure (HF) is a devastating disease leading to prolonged hospitalization, high morbidity and mortality rates, and increased costs. Well-established treatments for decompensated or unstable patients include medications and mechanical cardiac support devices. For acute HF decompensation, new devices are being developed to help relieve symptoms and recover heart and renal function in these patients. A recent device-based classification scheme, collectively classified as DRI₂P₂S, has been proposed to better describe these new device-based therapies based on their mechanism: dilators (increase venous capacitance), removers (direct removal of sodium and water), inotropes (increase left ventricular contractility), interstitials (accelerate removal of lymph), pushers (increase renal arterial pressure), pullers (decrease renal venous pressure), and selective (selective intrarenal drug infusion). In this review, we describe the new class of medical devices with the most current results reported in preclinical models and clinical trials.

We describe the use of a radiation dose-tracking system (Canon Medical Systems) that can help physicians provide patients with better care after higher radiation exposure dose following lengthy procedures. Original Contribution from Journal of Invasive Cardiology.

Background: Stem cell therapy may help restore cardiac function after acute myocardial infarction (AMI), but the optimal therapeutic cell type has not been identified.Methods: We examined the effects of CD34‐/CD45‐ human unrestricted somatic stem cells (USSCs) in pigs (n = 30) with an AMI created by a 90‐min occlusion of the left anterior descending coronary artery. Pigs were randomly assigned to receive either USSCs (302 ± 23 × 10⁶ cells) or phosphate‐buffered saline via 15 NOGA‐guided transendocardial injections 10 days after AMI. Cyclosporine A (10 mg/kg orally, twice a day) was started in all pigs 3 days before control or cell treatment. Cardiac function was assessed by echocardiography before injection and at 4 and 8 weeks after treatment. Serum titers for pig IgG antibodies against USSCs were also measured at these time points and before AMI.Results: Compared with control pigs, USSC‐treated pigs showed no significant differences in any of the functional parameters examined. USSC‐treated pigs showed variable increases in anti‐USSC IgG antibody titers in the blood and chronic inflammatory infiltrates at the cell injection sites. Immunohistochemical studies of the injection sites using human anti‐mitochondrial antibodies failed to detect implanted USSCs.Conclusions: We conclude that human USSCs did not improve cardiac function in a pig model of AMI. Cell transplantation in a xenogeneic setting may obscure the benefits of stem cell therapy.