Promise of blood- and bone marrow-derived stem cell transplantation for functional cardiac repair: putting it in perspective with existing therapy.
Intracoronary transplantation of peripheral blood- or bone marrow-derived cells, as tested in several recent trials, is associated with moderate increases in left ventricular (LV) ejection fraction (EF) and a small reduction of LV end-systolic volumes. Substantial variability exists between trials, and most of them are based on a small number of patients. Meta-analyses estimated an increase in EF of 3% to 4% more in comparison with control patients. In this review, the effects are put into perspective with established treatment options for acute myocardial infarction (AMI), such as thrombolysis and acute percutaneous interventions or pharmacotherapy aimed at favorably influencing the cardiac remodeling process. Changes in functional and morphometric parameters of LV performance after cell therapy appear to be in the range of effects observed with reperfusion therapy, pharmacotherapeutic interventions influencing the renin-angiotensin-aldosterone pathway, and beta-blockers after AMI.
Reffelmann
Thorsten
T
Klinik und Poliklinik für Innere Medizin B, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany. ThorstenReffelmann@web.de
Könemann
Stephanie
S
Kloner
Robert A
RA
D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery*; D036102:Peripheral Blood Stem Cell Transplantation; D033581:Stem Cell Transplantation; D013234:Stem Cells; D013318:Stroke Volume