Mechanisms Contributing to the Progression of Ischemic and Nonischemic Dilated Cardiomyopathy Possible Modulating Effects of Paracrine Activities of Stem Cells

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:66

Review

Kelkar, Anita A.¹  Butler, Javed²  Schelbert, Erik B.³  Greene, Stephen J.⁴  Quyyumi, Arshed A.¹  Bonow, Robert O.⁴  Cohen, Ira²  Gheorghiade, Mihai⁴  Lipinski, Michael J.⁵  Sun, Wei⁵  Luger, Dror⁵  Epstein, Stephen E.⁵ 

[1] Emory Univ, Div Cardiol, Atlanta, GA 30322 USA

[2] SUNY Stony Brook, Stony Brook, NY 11794 USA

[3] Univ Pittsburgh, Cardiol Div, Pittsburgh, PA USA

[4] Northwestern Univ, Feinberg Sch Med, Ctr Cardiovasc Innovat, Chicago, IL 60611 USA

[5] MedStar Washington Hosp Ctr, MedStar Heart & Vasc Inst, Washington, DC USA

关键词: cardiac;    cell- and tissue-based therapy;    extracellular matrix;    heart failure;    inflammation;    myocardium;    myocytes;    paracrine mechanisms;   

DOI  :  10.1016/j.jacc.2015.09.010

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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