Treatment of angina pectoris | Overview including symptoms and causes

Angina pectoris is a disease in which chest pressure and pain occur repeatedly because of insufficient blood flow to the heart. Symptoms are more likely to occur suddenly when oxygen demand in the heart increases, such as during exercise and stress. As the blood flow becomes further compromised, the patient is at risk of developing myocardial infarction. Fundamental improvements are sometimes difficult to achieve in severe or recurrent cases.

Stem cell therapy, which aims to regenerate the heart tissue itself, has drawn attention as a new option for treating angina pectoris in recent years. This article presents the outline, symptoms, and causes of angina pectoris as well as the potential of stem cell therapy in treating this disease and describes the flow of treatment.

What is angina pectoris?

Angina pectoris is a disease in which the narrowing of a coronary artery prevents sufficient delivery of oxygen and nutrients to the cardiac muscle, temporarily causing chest pain and pressure. If the coronary artery becomes blocked, resulting in total occlusion, the risk of developing myocardial infarction increases, which may be a life-threatening situation. Angina pectoris includes effort angina, where chest pain occurs only during physical exertion, and coronary spastic angina, which is characterized by chest pain that occurs even at rest, and both are attributed to myocardial ischemia (insufficient blood flow). A coronary artery becomes physically narrowed due to conditions such as atherosclerosis in some cases and temporary spasms of blood vessels in others. *1

Reference: NewHeart Watanabe Institute

Symptoms of angina pectoris

The main symptoms of angina pectoris are central or slightly left-sided chest pressure and squeezing pain. These symptoms have the following characteristics.

• Chest pressure and pain: The chest feels tight when the oxygen demand of the heart increases, such as during exercise or under stress. Pain may radiate to the left arm, back, and jaw.
• Short duration of attack: Symptoms usually subside within a few minutes (anginal attack). If it persists for a long time, myocardial infarction may have occurred.
• Cold sweat or shortness of breath: Chest pain is often accompanied by sweating, palpitation, and difficulty in breathing.
• Attacks when resting (coronary spastic angina): Spasms of blood vessels that cause chest pain may occur even in situations without exercise or stress, such as during sleep or upon waking.

Since symptoms often improve temporarily in mild cases of angina pectoris, the symptoms must not be overlooked so as to avoid progression. *2

*2 Sendai Kousei Hospital

Causes of angina pectoris

Angina pectoris occurs because of insufficient blood flow in the coronary arteries. Major causes include the following two factors:

• Coronary artery stenosis due to atherosclerosis (effort angina): Risk factors such as hypertension, dyslipidemia, diabetes mellitus, and smoking promote atherosclerosis, which narrows the coronary artery, thereby limiting blood flow and causing myocardial ischemia.
• Vasospasm (coronary spastic angina): Even if atherosclerosis is not present in the coronary artery itself, spasms of the vessels may suddenly occur, interrupting blood flow and causing chest pain. Smoking and stress are often the triggering factors.

In some cases, these factors overlap to lead to disease onset, and there is a lot of individual variation in the frequency, severity, and pattern of symptoms. *3

*3 Kindai University Hospital

Stem cell therapy as a promising radical treatment for angina pectoris

Currently, the use of stem cells is showing promise as a treatment for angina pectoris.

Here, we will explain what stem cells are and why they are attracting attention as a therapeutic method.

What is stem cell therapy?

Stem cell therapy is a type of regenerative medicine that repairs and regenerates damaged tissues using stem cells, which possess the ability to both self-renew and differentiate into multiple cell types. In the context of angina pectoris, stem cells have attracted attention because they potentially promote angiogenesis and enhance myocardial function in cases where the cardiac muscle and blood vessels are weakened.

Advantages of stem cell therapy

The following advantages are the reason stem cell therapy holds promise as a new therapeutic approach for angina pectoris.

• Regeneration of the cardiac muscle and blood vessels: Stem cell therapy repairs damaged cardiac muscle and blood vessels and promote the formation of new vessels (angiogenesis), thereby improving blood flow.
• Inflammatory suppression and immunomodulation: Stem cells secrete cytokines, which control excessive inflammation and immune response, thereby improving the tissue environment.
• Lower risk of side effects: When autologous stem cells are used, there is only a small chance that rejection will occur, and the burden on patients can be reduced.
• Can be used in combination with other therapies: When performed in combination with drug therapy or catheter therapy, stem cell therapy may synergistically alleviate the symptoms of angina pectoris and reduce the recurrence risk.

Reasons why stem cell therapy is effective

Stem cells are believed to have the ability to suppress inflammation and regenerate blood vessels and cardiomyocytes in a multifaceted manner. In angina pectoris, the myocardial function deteriorates if ischemia persists because of stenosis of the coronary artery resulting in insufficient blood flow to the cardiac muscle.
Stem cells are guided to the damaged area where they differentiate and secrete growth factors to promote angiogenesis and are thus expected to support the activation of cardiomyocytes. However, as the effects of the therapy vary depending on the medical condition of the patient and management status of risk factors, a treatment plan is drawn up after sufficient consultation with specialists.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

At the Regenerative Medicine Division of Korokai Medical Corporation, we administer stem cell therapy through the following process with the aim of alleviating angina pectoris.

1. Initial consultation and tests: We will assess cardiac function and the extent of stenosis of blood vessels using echocardiography, cardiac MRI, coronary artery CT, and other tests and determine the indication of stem cell therapy while considering treatment history and risk factors.
2. Stem cell collection and culture: Stem cells are extracted from the patient’s own bone marrow or fat, cultured, and grown under strict quality control.
3. Preparation of the treatment plan: A plan will be prepared for each patient by selecting the appropriate method (e.g., intravenous infusion, catheter) and frequency of stem cell administration as well as concomitant drug therapy to be used.
4. Administration of stem cells and follow-up: After returning the stem cells to the body, tests and medical examinations will be performed regularly to evaluate the improvement of cardiac function and presence or absence of adverse reactions. Additional dose administration may be considered, if necessary.

Stem cell therapy as regenerative medicine that has recently attracted attention

Angina pectoris is a disease in which chest pain and pressure are caused by insufficient blood supply to the heart. If left untreated, there is a risk of progression to myocardial infarction, and preventive measures such as drug therapy and catheter therapy must be taken from an early stage. However, fundamental recovery is difficult in cases of damage or functional decline. Stem cell therapy has recently attracted attention as a type of regenerative medicine that addresses the causes of angina pectoris through multifaceted effects such as angiogenesis and regeneration of cardiomyocytes.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and offers regenerative medicine according to each individual’s concerns based on novel comprehensive treatment strategies. To optimize the results, a combination of oral therapy, such as bioidentical hormone replacement therapy or peptide therapy, and stem cell therapy will be used.

*4 Source: Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo

 

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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue and then injecting them locally at the affected area or administering them via intravenous infusion.

[2] Risk of side effects
At the time of fat collection: Adverse reactions such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site may be observed.
At the time of stem cell administration: Adverse reactions such as pain at the injection site, allergic reaction, and pulmonary embolism may be observed.

[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
5th floor, Precious 18, 4-14-6 Minami-Azabu, Minato-ku, Tokyo
TEL:03-6277-4650

[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance.

For culture of approximately 100–180 million stem cells
*Since the number of stem cells that can be grown varies from person to person, it may be less than 100 million stem cells.
1 cycle costs 2.5 million yen (tax included)
3 cycles cost 7.2 million yen (payment in installments: 2.5 million yen each for the first and second cycles, 2.3 million yen for the third cycle)
5 cycles cost 11.5 million yen (tax included) (payment in installments: 2.5 million yen each for the first through fourth cycles, 1.5 million yen for the fifth cycle)

For culture of approximately 200–280 million stem cells
*Since the number of stem cells that can be grown varies from person to person, it may be less than 200 million stem cells.
1 cycle costs 3.8 million yen (tax included)
3 cycles cost 11.1 million yen (tax included) (payment in installments: 3.8 million yen each for the first and second cycles, 3.5 million yen for the third cycle)
5 cycles cost 17.5 million yen (tax included) (payment in installments: 3.8 million yen each for the first through fourth cycle, 2.3 million yen for the fifth cycle)
Please consult us for further details.

[5] Route of acquisition
Stem cells will be cultured at the affiliated CPC.

[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.

[7] Safety information from other countries
There are no reports on safety in other countries.
*Significant risks may not have been identified.

[8] The fact that it has not been approved
Drugs used in this treatment are yet to receive approval in accordance with the Pharmaceutical and Medical Device Act.

[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.

[10] Notification of regenerative medicine provision plans

To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.

Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230187
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3240017
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230218