Technical solutions to improve cardiac regenerative therapy

Abstract

The therapeutic options for patients suffering from ischemic heart disease (IHD) are limited, and worldwide 23 million patients suffer from heart failure (HF). Therefore there is a strong need for alternative therapies for IHD. Since cardiac regenerative therapies have shown promising results in basic science studies, the attention for cardiac regenerative therapy has been overwhelming in the last decade. Nevertheless the clinical benefits are still modest, and do not always prevent progression of the disease towards end stage HF. The appealing promise of cardiac regenerative therapy to be readily available as a low cost and effective treatment is once more accelerated by the enormous developments in the field of bio-technology in combination with a strong scientific competition. Besides the medical and biological aspects of the therapy, topics concerning the optimal injection strategy and the optimal endpoints to assess the therapy have been underexposed. Standard clinical techniques have been used, whereas specialized techniques might be more effective and better suited in the crucial phase of further development of a promising therapy. Efficient development, introduction and valorization of new techniques are the specialized skills of a medical engineer. This PhD Thesis project consists of three major topics: 1) A study was performed to address the technical challenges of cardiac regenerative therapy. 2) Development of an injection technique for application of cardiac regenerative therapy based on the gold standard infarct imaging technique. 3) Advanced measurement techniques were investigated to measure local cardiac function in order to establish constructive feedback for optimizing cardiac regenerative therapy.