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Stem Cells in the Treatment of Myocardial Infarction and Cardiomyopathy

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Stem Cells: Basics and Clinical Translation

Part of the book series: Translational Medicine Research ((TRAMERE,volume 1))

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Abstract

Cardiovascular investigators are currently investigating adult bone marrow stem cells, cardiac stem cells, and adipose stem cells as potential new regenerative cell treatments for patients with acute myocardial infarctions and cardiomyopathies. The initial ten-year experience with autologous, unfractionated bone marrow aspirates, which contain hematopoietic and mesenchymal stem cells (MSCs), suggested that patients with myocardial infarctions who receive these cells demonstrate 2–3 % increases in the left ventricular (LV) ejection fraction of the heart, 4.8 ml decreases in the left ventricular end-systolic volume (LVESV), and approximately 5 % reductions in infarction size without experiencing significant side effects from these cells. The bone marrow stem cells are thought to act by releasing biologically active factors that limit myocardial inflammation, injury, and necrosis. The LateTIME, the TIME, and the Swiss Myocardial Infarction trials have recently addressed the questions of the optimal time for autologous, unfractionated bone marrow cell administration after acute myocardial infarction and coronary angioplasty and whether these cells limit myocardial damage in comparison with the patients treated with percutaneous coronary angioplasty and current medical care without cell transplantation. In these studies, the myocardial infarction sizes and the left ventricular ejection fractions (LVEFs) were not significantly different between the cell-treated patients with standard medical care and patients treated with standard medical care without bone marrow cells (BMCs). The lack of differences between treatments may have been due to the performance of coronary angioplasty within 4–5 h of the onset of patient’s symptoms of myocardial infarction, but may also have been due to heterogeneous patient bone marrow cell populations, red blood cell contamination of stem cells, heparin inhibition of stem cell migration, and expulsion of the stem cells from the contracting heart shortly after injection. Current trials of patients with myocardial infarction are examining specific bone marrow stem cells including MSCs and CD34+ endothelial stem cells. In addition, cardiac stem cells isolated from human hearts are being investigated in the treatment of patients with infarcted hearts. Cardiac stem cell treatments in patients with infarcted hearts have reportedly decreased left ventricular infarct scar sizes by 11.9–15.7 g and increased left ventricular viable mass by 17.9–22.6 g. Successful cell-based therapy for patients with heart disease requires the close cooperation and interaction of basic scientists and clinicians throughout the world. In this manner, the cell-based therapy in the twenty-first century will offer new hope to the millions of patients with heart disease throughout the world who would otherwise suffer from the inexorable downward progression of heart disease, heart failure, and death.

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Acknowledgments

This work was support, in part, by grants from the Florida-King Biomedical Research Program, the Muscular Dystrophy Association, the Robert O. Law Foundation, and the Cornelius Foundation and by facilities at the James A. Haley Hospital and the University of South Florida College Of Medicine. Sections of this chapter were adapted from the author’s publications in Future Cardiology

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  1. Center for Cardiovascular Research and the James A. Haley Hospital, 13000 Bruce B. Downs Blvd, Tampa, FL, 33612, USA

    Robert J. Henning

  2. The University Of South Florida College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, Fl 33612, USA

    Robert J. Henning

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  1. Center of Excellence in Tissue Engineeri, Institute of Basic Medical Sciences School of Basic Medicine, Beijing, China

    Robert Chunhua Zhao

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Henning, R.J. (2015). Stem Cells in the Treatment of Myocardial Infarction and Cardiomyopathy. In: Zhao, R. (eds) Stem Cells: Basics and Clinical Translation. Translational Medicine Research, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7273-0_12

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