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Stem Cell Therapy to Improve Acute Myocardial Infarction Remodeling

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Stem Cell Therapy for Vascular Diseases

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Abstract

In the United States, a patient suffers from a myocardial infarction (MI) every 40 seconds, and heart disease remains the leading cause of death worldwide. Despite optimal medical and surgical care, one in every two patients who develops heart failure will die within 5 years. A series of pathological remodeling changes occur to compensate for the myocardium lost during an MI that lead to fibrosis, hypertrophy, and ventricular dilation, with the end-stage pathology often culminating in decreased ejection fraction (EF) and heart failure (HF). Post-MI myocardial recovery is worsened by the adult myocardium’s limited regenerative ability, particularly in an ischemic environment; accordingly, there is great interest in stem cell therapy to treat post-MI injury, and the field is rapidly evolving. Several endogenous and exogenous cellular sources have already been evaluated in clinical trials, with varied results and modest efficacy. Limitations surrounding stem cell treatment include lack of standardization across clinical trials, poor cellular retention and differentiation rates, suboptimal delivery methods, and limited source of candidate cells. In order to optimize stem cell efficacy, future work should focus on efficient generation of the optimal cellular source, development of delivery carriers capable of noninvasive delivery methods that improve cellular survival, and standardization of clinical trials to allow for meaningful comparisons.

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Abbreviations

3D:

Three dimensional

ADSC:

Adipose-derived stem cell

AMI:

Acute myocardial infarction

Ang-1α:

Angiopoietin-1α

BM:

Bone marrow

BM-MNC:

Bone marrow-derived mononuclear cell

BM-SC:

Bone marrow stem cells

CABG:

Coronary artery bypass grafting

CDC:

Cardiosphere-derived cells

CSC:

Cardiac stem cell

CVD:

Cardiovascular disease

ECM:

Extracellular matrix

EDV:

End-diastolic volume

EF:

Ejection fraction

EHT:

Engineered heart tissue

EPC:

Endothelial progenitor cell

ESC:

Embryonic stem cell

ESV:

End-systolic volume

FGF:

Fibroblast growth factor

Flk1:

Fetal liver kinase 1

GCP:

Glycolytic cardiac progenitor

GCSF:

Granulocyte colony-stimulating factor

HF:

Heart failure

HGF:

Hepatocyte growth factor

IC:

Intracoronary

IGF:

Insulin-like growth factor

ILK:

Integrin-linked kinase

IM:

Intramyocardial

iPSC:

Induced pluripotent stem cell

Isl1:

Insulin gene enhancer protein-1

IV:

Intravenous injection

LV:

Left ventricular

LVEDV:

Left ventricular end-diastolic volume

LVEF:

Left ventricular ejection fraction

LVESV:

Left ventricular end-systolic volume

MI:

Myocardial infarction

MMP:

Matrix metalloproteinase

MSC:

Mesenchymal stem cell

NSTEMI:

Non-ST segment elevation myocardial infarction

PCI:

Percutaneous coronary intervention

PEU:

Polyester urethane

PEUU:

Polyester urethane urea

PGS:

Polyglycerol sebacate

PU:

Polyurethane

SC:

Stem cell

Sca1:

Stem cell antigen-1

SDF1:

Stromal cell-derived factor 1

SMC:

Skeletal myoblast cell

SP:

Side population

SSEA:

Stage-specific embryonic antigen 1

STEMI:

ST-segment elevation myocardial infarction

VEGF:

Vascular endothelial growth factor

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  1. Vascular Biology and Therapeutics Program and the Departments of Surgery and Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA

    Jolanta Gorecka & Alan Dardik

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  1. Department of Surgery, Vascular Surgery Section, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

    Tulio Pinho Navarro

  2. Postgraduate Program in Sciences Applied to Surgery, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

    Lara Lellis Navarro Minchillo Lopes

  3. Vascular Biology and Therapeutics Program and the Departments of Surgery and Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA

    Alan Dardik

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Gorecka, J., Dardik, A. (2021). Stem Cell Therapy to Improve Acute Myocardial Infarction Remodeling. In: Navarro, T.P., Minchillo Lopes, L.L.N., Dardik, A. (eds) Stem Cell Therapy for Vascular Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-56954-9_14

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