This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Reffelmann, T. Articles by Kloner, R. A. Search for Related Content PubMed PubMed Citation Articles by Reffelmann, T. Articles by Kloner, R. A. Related Collections Related Article

VIEWPOINT

Promise of Blood- and Bone Marrow-Derived Stem Cell Transplantation for Functional Cardiac Repair

Putting It in Perspective With Existing Therapy

Thorsten Reffelmann, MD^_*,,,_*, Stephanie Könemann, MD^_* and Robert A. Kloner, MD, PhD, FACC^,

^_* Klinik und Poliklinik für Innere Medizin B, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Greifswald, Germany
The Heart Institute, Good Samaritan Hospital, Los Angeles, California
Division of Cardiology, Keck School of Medicine, University of Southern California, Los Angeles, California

Manuscript received June 20, 2008; revised manuscript received October 9, 2008, accepted October 13, 2008.

^_* Reprint requests and correspondence: Dr. Thorsten Reffelmann, Klinik und Poliklinik für Innere Medizin B, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald, Friedrich-Löffler Str. 23 a, 17475 Greifswald, Germany (Email: ThorstenReffelmann{at}web.de).

Intracoronary transplantation of peripheral blood- or bone marrow-derived cells, as tested in several recent trials, is associated with moderate increases in left ventricular (LV) ejection fraction (EF) and a small reduction of LV end-systolic volumes. Substantial variability exists between trials, and most of them are based on a small number of patients. Meta-analyses estimated an increase in EF of 3% to 4% more in comparison with control patients. In this review, the effects are put into perspective with established treatment options for acute myocardial infarction (AMI), such as thrombolysis and acute percutaneous interventions or pharmacotherapy aimed at favorably influencing the cardiac remodeling process. Changes in functional and morphometric parameters of LV performance after cell therapy appear to be in the range of effects observed with reperfusion therapy, pharmacotherapeutic interventions influencing the renin-angiotensin-aldosterone pathway, and beta-blockers after AMI.

Key Words: cell transplantation • acute myocardial infarction • remodeling • thrombolysis • immediate coronary angioplasty

Abbreviations and Acronyms   AMI = acute myocardial infarction   EF = ejection fraction   LV = left ventricular   MI = myocardial infarction

Related Article

Inside This Issue of JACC
J. Am. Coll. Cardiol. 2009 53: A20. [Full Text] [PDF]

This article has been cited by other articles:

				B. Assmus, M. Iwasaki, V. Schachinger, T. Roexe, M. Koyanagi, K. Iekushi, Q. Xu, T. Tonn, E. Seifried, S. Liebner, et al. Acute myocardial infarction activates progenitor cells and increases Wnt signalling in the bone marrow Eur. Heart J., December 15, 2011; (2011) ehr388v1. [Abstract] [Full Text] [PDF]

				M. J. Lovell and A. Mathur Republished review: Cardiac stem cell therapy: progress from the bench to bedside Postgrad. Med. J., August 1, 2011; 87(1030): 558 - 564. [Abstract] [Full Text] [PDF]

				J. W. Petersen, J. R. Forder, J. D. Thomas, L. A. Moye, M. Lawson, C. Loghin, J. H. Traverse, S. Baraniuk, G. Silva, C. J. Pepine, et al. Quantification of Myocardial Segmental Function in Acute and Chronic Ischemic Heart Disease and Implications for Cardiovascular Cell Therapy Trials: A Review From the NHLBI-Cardiovascular Cell Therapy Research Network J. Am. Coll. Cardiol. Img., June 1, 2011; 4(6): 671 - 679. [Abstract] [Full Text] [PDF]

				K. Malliaras and E. Marban Cardiac cell therapy: where we've been, where we are, and where we should be headed Br. Med. Bull., June 1, 2011; 98(1): 161 - 185. [Abstract] [Full Text] [PDF]

				D. M. Leistner, J. Schmitt, S. Palm, J. Klotsche, S. Estel, A. Fink, C. W. Israel, B. Assmus, G. Z. Duray, S. Dimmeler, et al. Intracoronary administration of bone marrow-derived mononuclear cells and arrhythmic events in patients with chronic heart failure Eur. Heart J., February 2, 2011; 32(4): 485 - 491. [Abstract] [Full Text] [PDF]

				M. J. Lovell and A. Mathur Cardiac stem cell therapy: progress from the bench to bedside Heart, October 1, 2010; 96(19): 1531 - 1537. [Abstract] [Full Text] [PDF]

				J. Guo, R. K. Li, and R. D. Weisel Back to the bench: The rejuvenation of stem cell therapy--the therapeutic potential of CD133+ progenitor cells J. Thorac. Cardiovasc. Surg., June 1, 2010; 139(6): 1369 - 1370. [Full Text] [PDF]

				J. Lee and C. M. Terracciano Cell therapy for cardiac repair Br. Med. Bull., June 1, 2010; 94(1): 65 - 80. [Abstract] [Full Text] [PDF]

				J. E. Kontaraki, F. I. Parthenakis, E. G. Nyktari, A. P. Patrianakos, and P. E. Vardas Myocardial gene expression alterations in peripheral blood mononuclear cells of patients with idiopathic dilated cardiomyopathy Eur J Heart Fail, June 1, 2010; 12(6): 541 - 548. [Abstract] [Full Text] [PDF]

				S. W. Kirschbaum, T. Springeling, E. Boersma, A. Moelker, W. J. van der Giessen, P. W. Serruys, P. J. de Feyter, and R. J. M. van Geuns Complete Percutaneous Revascularization for Multivessel Disease in Patients With Impaired Left Ventricular Function: Pre- and Post-Procedural Evaluation by Cardiac Magnetic Resonance Imaging J. Am. Coll. Cardiol. Intv., April 1, 2010; 3(4): 392 - 400. [Abstract] [Full Text] [PDF]

				H.-S. V. Chen, C. Kim, and M. Mercola Electrophysiological Challenges of Cell-Based Myocardial Repair Circulation, December 15, 2009; 120(24): 2496 - 2508. [Full Text] [PDF]

				J. A. Dixon, R. C. Gorman, R. E. Stroud, S. Bouges, H. Hirotsugu, J. H. Gorman III, T. P. Martens, S. Itescu, M. D. Schuster, T. Plappert, et al. Mesenchymal Cell Transplantation and Myocardial Remodeling After Myocardial Infarction Circulation, September 15, 2009; 120(11_suppl_1): S220 - S229. [Abstract] [Full Text] [PDF]

				F. Cao, D. Sun, C. Li, K. Narsinh, L. Zhao, X. Li, X. Feng, J. Zhang, Y. Duan, J. Wang, et al. Long-term myocardial functional improvement after autologous bone marrow mononuclear cells transplantation in patients with ST-segment elevation myocardial infarction: 4 years follow-up Eur. Heart J., August 2, 2009; 30(16): 1986 - 1994. [Abstract] [Full Text] [PDF]

				J. P. Singh Enabling Technologies for Homing and Engraftment of Cells for Therapeutic Applications J. Am. Coll. Cardiol. Intv., August 1, 2009; 2(8): 803 - 804. [Full Text] [PDF]

				K. D. Boudoulas and A. K. Hatzopoulos Cardiac repair and regeneration: the Rubik's cube of cell therapy for heart disease Dis. Model. Mech., July 1, 2009; 2(7-8): 344 - 358. [Abstract] [Full Text] [PDF]

				U. Landmesser Bone marrow cell therapy after myocardial infarction. What should we select? Eur. Heart J., June 1, 2009; 30(11): 1310 - 1312. [Full Text] [PDF]