10 Years of Intracoronary and Intramyocardial Bone Marrow Stem Cell Therapy of the Heart

  • Strauer B
  • Steinhoff G
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Abstract

Intracoronary and intramyocardial stem cell therapy aim at the repair of<br />compromised myocardium thereby-as a causal treatment-preventing<br />ventricular remodeling and improving overall performance. Since the<br />first-inhuman use of bone marrow stem cells (BMCs) after acute<br />myocardial infarction in 2001, a large number of clinical studies have<br />demonstrated their clinical benefit: BMC therapy can be performed with<br />usual cardiac catheterization techniques in the conscious patient as<br />well as also easily during cardiosurgical interventions. New York Heart<br />Association severity degree of patients as well as physical activity<br />improve in addition to ({''}on top{''} of) all other therapeutic<br />regimens. Stem cell therapy also represents an ultimate approach in<br />advanced cardiac failure. For acute myocardial infarction and chronic<br />ischemia, long-term mortality after 1 and 5 years, respectively, is<br />significantly reduced. A few studies also indicate beneficial effects<br />for chronic dilated cardiomyopathy. The clinical use of autologous BMC<br />therapy implies no ethical problems, when unmodified primary cells are<br />used. With the use of primary BMCs, there are no major stem cell-related<br />side effects, especially no cardiac arrhythmias and inflammation.<br />Various mechanisms of the stem cell action in the human heart are<br />discussed, for example, cell transdifferentiation, cell fusion,<br />activation of intrinsic cardiac stem cells, and cytokine-mediated<br />effects. New techniques allow point-of-care cell preparations, for<br />example, within the cardiac intervention or operation theater, thereby<br />providing short preparation time, facilitated logistics of cell<br />transport, and reasonable cost effectiveness of the whole procedure. The<br />3 main indications are acute infarction, chronic ischemic heart failure,<br />and dilated cardiomyopathy. Future studies are desirable to further<br />elucidate the mechanisms of stem cell action and to extend the current<br />use of intracoronary and/or intramyocardial stem cell therapy by larger<br />and presumably multicenter and randomized trials. (J Am Coll Cardiol<br />2011; 58: 1095-104) (C) 2011 by the American College of Cardiology<br />Foundation

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APA

Strauer, B.-E., & Steinhoff, G. (2011). 10 Years of Intracoronary and Intramyocardial Bone Marrow Stem Cell Therapy of the Heart. Journal of the American College of Cardiology, 58(11), 1095–1104. https://doi.org/10.1016/j.jacc.2011.06.016

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