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Unraveling the Mystery of Regenerative Medicine in the Treatment of Heart Failure

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Handbook of Stem Cell Therapy

Abstract

Despite many advancements that have been made in the field of cardiovascular research, heart failure is still associated with a poor prognosis and high mortality worldwide. The discovery that adult cardiomyocytes have an extremely low turnover rate has prompted researchers to investigate stem cells as a therapeutic option for cardiac regeneration. With stem cell therapy now approaching its third decade, numerous clinical trials have been completed and questions surrounding stem cell therapy are starting to be answered. It is now fairly well established that stem cell therapy has a positive safety profile, but only has produced neutral to moderately positive clinical outcomes. It is also clear that current stem cell therapies lack a significant ability to engraft and remuscularize the myocardium, suggesting cardiac repair occurs primarily through paracrine signaling mechanisms. Innovative strategies involving cardiac bioengineering, cell-free biomolecules, and combination therapies likely hold the key to advancing the field to the next stage. Looking ahead, we remain cautiously optimistic that stem cell therapeutics will have a significant place in the future of cardiovascular treatments, but there are still many questions that need to be answered before routine clinical application is possible.

MRH and IW collected the data and wrote this chapter. RA devised the project, developed the main conceptual ideas and edited the manuscript. All authors revised and approved the final version

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Abbreviations

AAV:

Adeno-associated virus

ACC/AHA:

American College of Cardiology and the American Heart Association

ANP:

Atrial natriuretic peptide

BMDSC:

Bone marrow-derived stem cell

BMMNC:

Bone marrow mononuclear cell

BNP:

Brain natriuretic peptide

CABG:

Coronary artery bypass grafting

CDC:

Cardiosphere-derived cell

CDCP:

Center for Disease Control and Prevention

CM:

Cardiomyocyte

CPC:

Cardiac progenitor cell

CSC:

Cardiac stem cell

ECM:

Extracellular matrix

EDV:

End diastolic volume

EF:

Ejection fraction

ESC:

Embryonic stem cell

ESV:

End systolic volume

FGF:

Fibroblast growth factor

hESC-CP:

Human embryonic stem cell cardiac progenitor

HF:

Heart failure

HFpEF:

HF with preserved ejection fraction

HFrEF:

HF with reduced ejection fraction

IC:

Intracoronary

IGF-1:

Insulin-like growth factor-1

IM:

Intramuscular

iPSC:

Induced-pluripotent stem cell

IV:

Intravenous

LV:

Left ventricular

LVEDV:

Left ventricular end diastolic volume

LVEF:

Left ventricular ejection volume

LVESV:

Left ventricular end systolic volume

MI:

Myocardial infarction

MLHFQ:

Minnesota Living with HF Questionnaire

MPC:

Mesenchymal precursor cell

MSC:

Mesenchymal stem cell

NYHA:

New York Heart Association

PCI:

Percutaneous coronary intervention

PDGF-B:

Platelet-derived growth factor B

PSC:

Pluripotent stem cell

SDF-1:

Stromal cell-derived factor-1

SM:

Skeletal myoblast

VEGF:

Vascular endothelial growth factor

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© 2022 Springer Nature Singapore Pte Ltd.

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Rheault-Henry, M., White, I., Atoui, R. (2022). Unraveling the Mystery of Regenerative Medicine in the Treatment of Heart Failure. In: Haider, K.H. (eds) Handbook of Stem Cell Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-19-2655-6_16

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