TAMPA — On Sept. 14, 46-year-old Hatem Faraj suffered a major heart attack while watching Monday Night Football on TV.
Tuesday, the Wesley Chapel man joined the cutting edge of heart disease research, becoming the area's first participant in a study to see if a patient's own stem cells can regenerate his damaged heart muscle.
The procedure he had at Pepin Heart at University Community Hospital in Tampa is part of a University of Florida research program. Its aim is improving chances of long-term survival and reducing heart transplants. Using stem cells to regenerate heart tissue has been studied for several years in animals and humans, producing mixed results. Still, the therapy is considered promising for millions of Americans with heart failure.
"It's exciting, but we don't know if it's going to be effective yet," said Dr. Fadi Matar, director of the coronary care unit at Tampa General Hospital, who is not directly involved in the study.
The most appealing part of the study is that a patient's own stem cells are used, he said. "It won't hurt you to participate," Matar said. "I would encourage physicians to refer their patients."
Researchers are looking at many questions surrounding the therapy: how many stem cells to infuse into the heart, how long it will take to see results, how soon after a cardiac event should treatment be delivered, how much tissue regeneration can patients expect. The long-term effects of such therapy are unknown.
The University of Florida is one of five U.S. medical centers involved in three federally funded stem cell regeneration clinical trials. Bay area hospitals with cardiac care programs were asked help enroll the almost 300 patients needed for the 2 1/2-year-long study.
"It will be a challenge," says Dr. Charles Lambert, medical director at Pepin, the first satellite center in Florida to recruit a study participant. Lambert says that's because patients who have just survived a heart attack must undergo two medical procedures: one to harvest bone marrow in order to get the stem cells, and another to infuse cells in the heart.
Two-thirds of participants will be infused with stem cells; the others will receive a cell-free solution. Patients — including Faraj — won't know if they actually receive stem cells, standard protocol in medical research.
"But people stand to benefit from the infusion procedure itself even if they don't receive active cells. That treatment alone stimulates the heart and new blood vessels," says Dr. Carl Pepine, the principal investigator and UF professor of cardiovascular medicine who was in the catheterization lab at the Tampa hospital during Faraj's procedure.
Because it was the first procedure at a satellite center, a UF medical team traveled to Tampa to assist with the bone marrow harvest earlier Tuesday and drive the cells back to Gainesville. There, scientists isolated the heart and vascular stem cells, extracted and purified them and handed them off to a second medical team. They drove the little bag of cells, about six tablespoons worth, back to Tampa.
Faraj was only mildly sedated during the hourlong infusion, in which the stem cells (or a cell-free solution) were sent to his heart through a catheter inserted in the groin and threaded through the femoral artery to his heart. He was smiling and talking with hospital staff immediately afterward.
A fumble, then pain
Faraj suffered a major heart attack on Sept. 14 while watching Monday Night Football. He says the pain started when his beloved Buffalo Bills fumbled the ball, losing the game to the New England Patriots in the final seconds of the game.
"It was very sharp chest pain, like somebody stabbing me. My left arm became numb, and I was sweating like I was in a shower," says Faraj. His son called 911 within five minutes and paramedics rushed Faraj to UCH, where doctors performed an emergency catheterization procedure to open a fully blocked artery on the left side of his heart. Faraj was released from the hospital four days later and soon was back on the golf course.
Pepine says the risk of heart failure several years after a major heart attack like Faraj's is very high, even with successful treatment at the time of the attack.
"Even though he looks good now, his heart is still damaged," Pepine said.
Faraj, a Palestinian who has lived in the bay area since 1995, researched the procedure, spoke with several physicians, his wife and adult children and decided he had nothing to lose.
"I figured why not? It's my cells going in my heart. It's not going to hurt," said Faraj, who owns two local convenience stores. "If it works, it would be like I never had a heart attack."
Like others in the study, he will be followed closely and will be evaluated using a special MRI scan of the heart six months after the infusion to determine whether new tissue is growing.
Apart from the study, Faraj is taking action to extend his life. For 30 years, he smoked a pack and a half of Marlboro Lights a day. He quit the day of his heart attack.
After seeing the worry on the faces of his wife and four children, he says he can't smoke again.
Irene Maher may be reached at firstname.lastname@example.org.