Stem Cell therapy for Myocardial Infarction and Heart Failure

Abstract

The cell-based therapy is being envisaged as a potential strategy
for myocardial repair in patients suffering from acute myocardial infarction or ischaemic heart failure. The present phase of
knowledge allows us to expect the use of skeletal myoblasts or
autologous stem cells to become safe, feasible and effective.
Available data suggest the benefit of the use of myoblasts in
cardiac function with improvement of the left ventricular ejection
fraction, decreasing of end diastolic and end systolic volumes.
Increasing of the contractility of the ischaemic area, diminishing
of the functional NYHA class and decreasing of the new cases
of revascularization and hospitalizations are envisaged. Nevertheless the mechanisms by which these cells provide repair are
still unknown. However the cell differentiation into myocites, the
promotion of angiogenesis, paracrine factors secretion which
increase the function of the surviving myocites, inhibition of cell
matrix destruction and of the apoptosis of cardiomyocites and
fusion between transplanted cells and resident cells have been
proposed as possible explanations.
We must underline that neither the best locus to collect stem
cells or the best way of their management is cleared up.
There are also some issues related to technical difficulties
and emerging complications that are still not solved. Hopefully
undergoing research will enlighten most of our doubts and will
allow us to reach conclusions.