PMID- 21063937
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20211020
IS  - 1534-3189 (Electronic)
IS  - 1092-8464 (Linking)
VI  - 12
IP  - 6
DP  - 2010 Dec
TI  - Current and future status of stem cell therapy in heart failure.
PG  - 614-27
LID - 10.1007/s11936-010-0099-0 [doi]
AB  - As heart transplantation and mechanical assist technology are inadequate 
      solutions for the growing clinical epidemic of heart failure, myocardial 
      regeneration has moved to the forefront. Multiple laboratories using a variety of 
      cell types have demonstrated myocardial repair in different animal models. 
      Translating these results into clinical practice through clinical trial research 
      has thus far proved challenging. Amassing clinical evidence suggests that cell 
      therapy is safe and offers a modest clinical benefit, but the long-term effect of 
      such therapy as well as the overall impact on the natural progression of heart 
      failure and, ultimately, survival are unknown. Furthermore, cost-benefit analysis 
      of such therapy, which will likely become increasingly important as health care 
      reform takes shape, has not been examined to any degree. Although scientific 
      competition has driven this field with remarkable speed, it is also responsible 
      for its fragmentation, with multiple avenues of pursuit happening in parallel. 
      Consensus opinion is absent with respect to mechanism of action, effectiveness of 
      cell type or delivery method, timing and dosing of cell therapy, adjunctive 
      medication or therapies, and optimum cell type or combination of cell types. 
      Nevertheless, in the arena of clinical medicine, ease of cell availability and 
      cell delivery has proved paramount to cell type selection. The flourish of 
      clinical trials investigating bone marrow-derived stem cells (BMSCs) delivered 
      via direct intracoronary injection testifies to this opinion. The modest 
      improvements in cardiac function demonstrated in trials to date will likely not 
      have a significant clinical impact. We expect, however, that scientific 
      competition will make continued contributions over the next decade that will 
      propel the field forward, resulting in more pronounced clinical benefits in 
      future trials. The authors further believe that the realization of true cardiac 
      regeneration will require the use of autologous cells more capable of retention 
      and differentiation to cardiac cell lineages. We believe that endogenous cardiac 
      progenitor cells have superior regenerative potential to current cell types in 
      this regard. The difficulty in accessing, isolating, and expanding these cells 
      has resulted in less preclinical and clinical interest. Ongoing investigation 
      will better define the capabilities of these cardiac progenitor cells.
FAU - D'Alessandro, David A
AU  - D'Alessandro DA
AD  - Department of Cardiovascular and Thoracic Surgery, Montefiore Medical 
      Center/Albert Einstein College of Medicine, 3400 Bainbridge Avenue, New York, NY, 
      10467, USA.
FAU - Michler, Robert E
AU  - Michler RE
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Treat Options Cardiovasc Med
JT  - Current treatment options in cardiovascular medicine
JID - 9815942
EDAT- 2010/11/11 06:00
MHDA- 2010/11/11 06:01
CRDT- 2010/11/11 06:00
PHST- 2010/11/11 06:00 [entrez]
PHST- 2010/11/11 06:00 [pubmed]
PHST- 2010/11/11 06:01 [medline]
AID - 10.1007/s11936-010-0099-0 [doi]
PST - ppublish
SO  - Curr Treat Options Cardiovasc Med. 2010 Dec;12(6):614-27. doi: 
      10.1007/s11936-010-0099-0.