Autologous Cell-Based Therapy for Ischemic Heart Disease: Clinical Evidence, Proposed Mechanisms of Action, and Current Limitations

Cell-based therapy is a promising approach for cardiac repair in patients with coronary artery disease. In preclinical and early clinical studies, investigators have preliminary evidence showing that stem cell therapy can safely and effectively improve myocardial perfusion and left ventricular function. Cardiac stem cell therapy may decrease left ventricular remodeling in cases of myocardial infarction and may alleviate symptoms and prevent cardiac enlargement in chronic ischemic heart disease. Various mechanisms, including paracrine effects, are believed to contribute to stem cell-mediated cardiac repair. Further studies are needed to determine the optimal timing of therapy, best mode of delivery, and most effective cell dose. Cardiac stem cell therapy promises to become an important option for treating patients with coronary artery disease. (C) 2009 Wiley-Liss, Inc.