The role of cardiac electrophysiology in myocardial regenerative stem cell therapy.
Recent advances in stem cell biology and tissue engineering have put forth new therapeutic paradigms for treatment of myocardial disease. The aim of stem cell therapy for myocardial regeneration has been directed to induce angiogenesis for ischemic heart disease and/or introduction of new cardiomyocytes to improve the mechanical function of the failing heart. Encouraged by positive preliminary results in mouse models of myocardial infarction, clinical trials have utilized autologous skeletal myoblasts and bone-marrow-derived stem cells to treat patients in various clinical settings including acute myocardial injury, chronic angina, and heart failure. These studies have collectively shown, at best, modest improvement in cardiac function. This may be due to the fact that there is little evidence to support actual formation and/or integration of transplanted cells into the recipient myocardium. More recent and emerging data supports the finding that electrical stimulation may be an effective catalyst for sustained functional organization, integration, and maturation of transplanted cell populations into the host myocardium. A therapeutic model that utilizes electrical stimulation and/or achieves cardiac resynchronization in conjunction with stem cell transplantation may be an effective means to achieve successful myocardial regenerative therapy.
Division of Cardiovascular Medicine, Department of Medicine, LAC + USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Grace
G
Huang
Mohammad
M
Pashmforoush
Brile
B
Chung
Leslie A
LA
Saxon
D000818:Animals; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D006331:Heart Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D012038:Regeneration; D055153:Stem Cell Niche; D033581:Stem Cell Transplantation; D016896:Treatment Outcome