Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 66, Issue 18, Pages 2038-2047Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2015.09.010
Keywords
cardiac; cell- and tissue-based therapy; extracellular matrix; heart failure; inflammation; myocardium; myocytes; paracrine mechanisms
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Over the past 1.5 decades, numerous stem cell trials have been performed in patients with cardiovascular disease. Although encouraging outcome signals have been reported, these have been small, leading to uncertainty as to whether they will translate into significantly improved outcomes. A reassessment of the rationale for the use of stem cells in cardiovascular disease is therefore timely. Such a rationale should include analyses of why previous trials have not produced significant benefit and address whether mechanisms contributing to disease progression might benefit from known activities of stem cells. The present paper provides such a reassessment, focusing on patients with left ventricular systolic dysfunction, either nonischemic or ischemic. We conclude that many mechanisms contributing to progressive left ventricular dysfunction are matched by stem cell activities that could attenuate the myocardial effect of such mechanisms. This suggests that stem cell strategies may improve patient outcomes and justifies further testing. (C) 2015 by the American College of Cardiology Foundation.
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