Therapeutic potentials of stem cells in cardiac diseases.
Coronary heart disease and chronic heart failure are common diseases and have an increasing frequency. Although interventional and conventional drug therapy may delay ventricular remodelling, there is no basic therapeutic regime available for preventing or even reversing this process. Chronic coronary artery disease and heart failure impair quality of life and are associated with subsequent worsening of the cardiac pump function. Numerous studies carried out in the past few years have demonstrated, that the intracoronary stem cell therapy has to be considered as a safe therapeutic procedure in heart disease, when destroyed and/or compromised heart muscle must be regenerated. This kind of cell therapy with autologous bone marrow cells is completely justified ethically, except for the small numbers of patients with direct or indirect bone marrow disease (e.g. myeloma, leukemic infiltration) in whom there would be lesions of mononuclear cells. Several preclinical as well as clinical trials have shown that transplantation of autologous bone marrow cells or precursor cells improved cardiac function after myocardial infarction and in chronic coronary heart disease. The age of infarction seems to be irrelevant to regenerative potency of stem cells, since stem cells therapy in old infarctions (many years old) is almost equally effective in comparison to previous infarcts. Further indications are non-ischemic cardiomyopathy (dilatative cardiomyopathy) and heart failure due to hypertensive heart disease.
Strauer
B E
BE
Department of Cardiology, Pneumology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany.
Schannwell
C M
CM
Brehm
M
M
D053687:Adult Stem Cells / Q000637:transplantation; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000818:Animals; D016026:Bone Marrow Transplantation / Q000379:methods*; D002404:Catheterization / Q000379:methods; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000628:therapy; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D006331:Heart Diseases / Q000601:surgery / Q000628:therapy*; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D039902:Multipotent Stem Cells / Q000637:transplantation; D009203:Myocardial Infarction / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012038:Regeneration; D014182:Transplantation, Autologous; D016896:Treatment Outcome