Stem cell therapy in end-stage ischaemic heart failure: a catheter-based therapeutic strategy targeting myocardial viability
Department of Adult Cardiology, Texas Heart Institute, St. Luke's Episcopal Hospital, 6624 Fannin, Suite 2220, Houston, TX 77030, USA
* Corresponding author. Tel: +1 713 791 9400; fax: +1 713 795 5651. E-mail address: eperin{at}crescentb.net
Recent evidence that the adult heart can repair itself through the proliferation of cardiac precursor cells and the recruitment and engraftment of bone marrow-derived precursor cells has stimulated interest in stem cell therapy for cardiac diseases. Although preclinical studies have shown the efficacy of stem cell treatment, numerous controversies exist, and many basic questions still await answers. Meanwhile, clinical trials of stem cell therapy continue to advance. Our group has focused on using stem cells to treat patients with end-stage ischaemic heart failure who are ineligible for surgical or percutaneous revascularization. The preliminary results of the phase I trial are encouraging but need to be reproduced before larger randomized trials can be attempted. This review covers some of the most important clinical developments in targeted, transendocardially delivered stem cell therapy for end-stage ischaemic heart failure.
Key Words: Stem cell therapy Cardiac Ischaemic heart failure Myocardial viability Transendocardial stem cell delivery Bone marrow-derived mononuclear cells Electromechanical mapping