Treating Cardiac Disorders with Stem Cells

  • Christine Mummery
Part of the Stem Cell Biology and Regenerative Medicine book series (STEMCELL)


Heart failure is one of the leading causes of death in the western world and its incidence is increasing in the east. One of its causes is myocardial infarction which results in loss of muscle mass through death of cardiomyocytes. Replacing these by transplanting stem cells or encouraging cells in the heart itself to multiply are among the ways being investigated to prevent heart failure developing. The only stem cells which can form cardiomyocytes though are pluripotent stem cells, until recently only available from human embryos. Other types of (adult) stem are not able to form cardiomyocytes but, if transplanted, may help the heart recover and be of short term benefit through other mechanisms. One area using human embryonic stem cells is controversial because of its ethics, the other because of its sometimes disputed clinical outcome. Here, a critical overview of the issues is presented.


Cell therapy Stem cells Cardiomyocytes Heart infarct Clinical trials 



Research by CLM cited in this review is supported by the Netherlands Heart Foundation, FP6 EU Heart Development and Heart Repair (LSHM-CT-2005-018630), ZonMW Dieren Alternatieven, and BSIK Stem Cells in Development and Disease.


  1. 1.
    Orlic D, Kajstura J, Chimenti S, Jakoniuk I, Anderson SM, Li B et al. Bone marrow cells regenerate infarcted myocardium. Nature 2001; 410:701–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Murry CE, Soonpaa MH, Reinecke H, Nakajima H, Nakajima HO, Rubart M et al. Haematopoietic stem cells do not transdifferentiate into cardiac myocytes in myocardial infarcts. Nature 2004; 428:664–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Balsam LB, Wagers AJ, Christensen JL, Kofidis T, Weissman IL, Robbins RC. Haematopoietic stem cells adopt mature haematopoietic fates in ischaemic myocardium. Nature 2004; 428:668–73PubMedCrossRefGoogle Scholar
  4. 4.
    Nygren JM, Jovinge S, Breitbach M, Säwén P, Röll W, Hescheler J et al. Bone marrow-derived hematopoietic cells generate cardiomyocytes at a low frequency through cell fusion, but not transdifferentiation. Nat Med. 2004; 10:494–501.PubMedCrossRefGoogle Scholar
  5. 5.
    Terada N, Hamazaki T, Oka M, Hoki M, Mastalerz DM, Nakano Y et al. Bone marrow cells adopt the phenotype of other cells by spontaneous cell fusion. Nature 2002; 416:542–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Rosenzweig A. Cardiac cell therapy – mixed results from mixed cells. N Engl J Med. 2006; 355:1274–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Janssens S, Dubois C, Bogaert J, Theunissen K, Deroose C, Desmet W et al. Autologous bone marrow-derived stem-cell transfer in patients with ST-segment elevation myocardial infarction: double-blind, randomised controlled trial. Lancet 2006; 367:113–21.PubMedCrossRefGoogle Scholar
  8. 8.
    van Ramshorst J, Bax JJ, Beeres SL, Dibbets-Schneider P, Roes SD, Stokkel MP et al. Intramyocardial bone marrow cell injection for chronic myocardial ischemia: a randomized controlled trial. JAMA 2009; 301:1997–2004.PubMedCrossRefGoogle Scholar
  9. 9.
    Passier R, van Laake LW, Mummery C. Stem cell-based therapy and lessons from the heart. Nature 2008; 453:322–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Wu SM, Chien KR, Mummery C. Origins and fates of cardiovascular progenitor cells. Cell 2008; 132:537–43.PubMedCrossRefGoogle Scholar
  11. 11.
    Martin-Puig S, Wang Z, Chien KR. Lives of a heart cell: tracing the origins of cardiac ­progenitors. Cell Stem Cell 2008; 2:320–31.PubMedCrossRefGoogle Scholar
  12. 12.
    Laflamme MA, Chen KY, Naumova AV, Muskheli V, Fugate JA, Dupras SK et al. Cardiomyocytes derived from human embryonic stem cells in pro-survival factors enhance function of infarcted rat hearts. Nat Biotechnol. 2007; 25:1015–24.PubMedCrossRefGoogle Scholar
  13. 13.
    van Laake LW, Passier R, Monshouwer-Kloots J, Verkleij AJ, Lips DJ, Freund C et al. Human embryonic stem cell-derived cardiomyocytes survive and mature in the mouse heart and transiently improve function after myocardial infarction. Stem Cell Research 2007; 1:9–24.PubMedCrossRefGoogle Scholar
  14. 14.
    van Laake LW, Passier R, Doevendans PA, Mummery CL. Human embryonic stem cell-derived cardiomyocytes and cardiac repair in rodents. Circ Res. 2008; 102:1008–10.PubMedCrossRefGoogle Scholar
  15. 15.
    Tomescot A, Leschik J, Bellamy V, Dubois G, Messas E, Bruneval P et al. Differentiation in vivo of cardiac committed human embryonic stem cells in postmyocardial infarcted rats. Stem Cells 2007; 25:2200–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Smits AM, van Laake LW, den Ouden K, Schreurs C, Szuhai K, van Echteld CJ et al. Human cardiomyocyte progenitor cell transplantation preserves long-term function of the infarcted mouse myocardium. Cardiovasc Res. 2009; 83:527–8.PubMedCrossRefGoogle Scholar
  17. 17.
    ISSCR guidelines for the clinical translation of stem cells. Curr Protoc Stem Cell Biol. 2009 Apr; Appendix 1: Appendix 1B.Google Scholar
  18. 18.
    Hyun I, Lindvall O, Ahrlund-Richter L, Cattaneo E, Cavazzana-Calvo M, Cossu G et al. New ISSCR guidelines underscore major principles for responsible translational stem cell research. Cell Stem Cell 2008; 3:607–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Christine Mummery
    • 1
  1. 1.Department of Anatomy and EmbryologyLeiden University Medical CenterLeidenThe Netherlands

Personalised recommendations