Haema 2013; 4(3):292-300
by Anna G. Dagre
Cardiac Catheterization Laboratory, Thriassio General Hospital of Elefsis, Athens, Greece
Abstract
Cell-based therapy for cardiovascular diseases has emerged as a highly promising therapeutic approach that will expand the benefits obtained with current pharmacologic and revascularization approaches by directly reversing scar formation and promoting myocardial regeneration. The 3 main indications of cell-based therapy in cardiovascular disease are: acute infarction, chronic ischemic heart failure, and dilated cardiomyopathy. Clinical trials employing bone marrow stem cells (BMSCs) have demonstrated efficacy in infarct size reduction and regional wall contractility improvement. A few studies also indicate beneficial effects for chronic dilated cardiomyopathy. Regarding delivery methods, the safety of catheter-based, transendocardial stem cell injection has been established. BMSC therapy can be performed with usual cardiac catheterization techniques in the conscious patient, as well as during cardiosurgical interventions. The next stage of development for the clinical use of cell therapy should focus on the standardization of BμSC harvesting and administration methods, as well as on the investigation of novel cell type(s) and/or cell combinations through randomized trials. Furthermore, it is of imperative importance to elucidate the mechanisms by which various stem cells interact with host cells and/or each other, in order to optimize their regenerative effects.