Blood supply of the graft after cellular cardiomyoplasty.
Cellular cardiomyoplasty is under extensive investigation as a potential therapeutic strategy after myocardial infarction, in congestive heart failure and chronic ischemic heart disease. Various cell sources and techniques for transplantation have been studied in animal models of cardiac disease. The initial goal of replacing myocardial scar tissue by vital myocardial cells, integrated into the host, simultaneously beating and contributing to systolic force, has not yet been accomplished. However, most experimental models provided evidence for enhanced vascularization after cell transplantation. In some investigations, neovascularization was also shown to be accompanied by increased myocardial perfusion. Mechanisms by which vascularization occurs have not been fully elucidated: either the transplanted cells provide an angiogenic stimulus, involving various paracrine or hormone-like factors, which induces the formation of a new vasculature or, depending on the source of transplanted cells, the cells incorporate into the vascular network after proliferation and differentiation. This review summarizes research that specifically studied the occurrence, magnitude and mechanisms of enhanced myocardial blood supply after cellular cardiomyoplasty.
Reffelmann
Thorsten
T
The Heart Institute, Good Samaritan Hospital, Division of Cardiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90017-2395, USA. thorstenreffelmann@web.de
Kloner
Robert A
RA
D018421:Cardiomyoplasty / Q000379:methods*; D017690:Cell Transplantation; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000502:physiology; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy