title: Cell therapy for human ischemic heart diseases: critical review and summary of the clinical experiences.
abstract: A decade ago, stem or progenitor cells held the promise of tissue regeneration in human myocardium, with the expectation that these therapies could rescue ischemic myocyte damage, enhance vascular density and rebuild injured myocardium. The accumulated evidence in 2014 indicates, however, that the therapeutic success of these cells is modest and the tissue regeneration involves much more complex processes than cell-related biologics. As the quest for the ideal cell or combination of cells continues, alternative cell types, such as resident cardiac cells, adipose-derived or phenotypic modified stem or progenitor cells have also been applied, with the objective of increasing both the number and the retention of the reparative cells in the myocardium. Two main delivery routes (intracoronary and percutaneous intramyocardial) of stem cells are currently used preferably for patients with recent acute myocardial infarction or ischemic cardiomyopathy. Other delivery modes, such as surgical or intravenous via peripheral veins or coronary sinus have also been utilized with less success. Due to the difficult recruitment of patients within conceivable timeframe into cardiac regenerative trials, meta-analyses of human cardiac cell-based studies have tried to gather sufficient number of subjects to present a statistical compelling statement, reporting modest success with a mean increase of 0.9-6.1% in left ventricular global ejection fraction. Additionally, nearly half of the long-term studies reported the disappearance of the initial benefit of this treatment. Beside further extensive efforts to increase the efficacy of currently available methods, pre-clinical experiments using new techniques such as tissue engineering or exploiting paracrine effect hold promise to regenerate injured human cardiac tissue.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Noemi
authors.initials: N
authors.lastname: Pavo
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Silvia
authors.initials: S
authors.lastname: Charwat
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Noemi
authors.initials: N
authors.lastname: Nyolczas
authors.affiliation: Department of Biomedical Laboratory and Imaging Science, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Jakab
authors.affiliation: Exercise Biochemistry Laboratory, The University of Memphis, Department of Health and Sport Sciences, Memphis, TN, USA.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Murlasits
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Jutta
authors.initials: J
authors.lastname: Bergler-Klein
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Mariam
authors.initials: M
authors.lastname: Nikfardjam
authors.affiliation: Department of Cardiology, University of Medicine and Pharmacy Tirgu Mures, Romania.
authors.forename: Imre
authors.initials: I
authors.lastname: Benedek
authors.affiliation: Department of Cardiology, University of Medicine and Pharmacy Tirgu Mures, Romania.
authors.forename: Teodora
authors.initials: T
authors.lastname: Benedek
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Imre J
authors.initials: IJ
authors.lastname: Pavo
authors.affiliation: Internal Medicine, Mayo Graduate School of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.affiliation: 3(rd) Dept. Cardiology and Emergency Medicine, Wilhelminen hospital, Vienna, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.affiliation: Department of Cardiology, Medical University of Vienna, Austria. Electronic address: mariann.gyongyosi@meduniwien.ac.at.
authors.forename: Mariann
authors.initials: M
authors.lastname: Gyöngyösi
mesh_terms: D002986:Clinical Trials as Topic; D006321:Heart / Q000503:physiopathology; D006801:Humans; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy*; D012038:Regeneration; D033581:Stem Cell Transplantation; D016896:Treatment Outcome
keywords: Cardiac regeneration; Cardio-myogenic stem and progenitor cells; Human clinical trial; Intracoronary delivery; Intramyocardial injection; Myocardial infarction; Review