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Optimizing Stem Cell Therapy for Cardiac Repair Following a Myocardial Infarction

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Cardiac Remodeling

Part of the book series: Advances in Biochemistry in Health and Disease ((ABHD,volume 5))

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Abstract

An extensive myocardial infarction (MI) frequently results in postinfarct remodelling which can lead to heart failure. Emergency percutaneous coronary intervention (PCI) has reduced the mortality of ST-elevation MI, and the use of beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), and anticoagulants has improved the morbidity. However, progressive ventricular dysfunction is increasingly common. New treatments are urgently needed for MI survivors to prevent pathological remodelling and functional loss. Replacing the cells lost during the infarct might limit detrimental remodelling, but none of the proposed treatments has been shown to completely restore beating cardiomyocytes. Stem cell transplantation was originally proposed to replace these lost cells, but extensive animal and human studies have suggested that the benefits of cell implantation were the result of paracrine effects. Several stem cell populations which improved ventricular function in preclinical studies have also been beneficial in clinical trials to treat post-myocardial infarction remodelling. However, most of these trials had mixed results, highlighting the need for further research into the mechanisms responsible for improved cardiac function and the need to develop new treatment strategies to augment the beneficial effects of stem cell transplantation.

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Author information

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada

    Kaustabh Singh, Keith R. Brunt, Richard D. Weisel & Ren-Ke Li

  2. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada

    Kaustabh Singh & Ren-Ke Li

  3. MaRS Centre, Toronto Medical Discovery Tower, 3rd floor, Rm 3-702, 101 College Street, Toronto, ON, Canada, M5G 1L7

    Ren-Ke Li

Authors
  1. Kaustabh Singh
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  2. Keith R. Brunt
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  3. Richard D. Weisel
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  4. Ren-Ke Li
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Corresponding author

Correspondence to Ren-Ke Li .

Editor information

Editors and Affiliations

  1. Walter MacKenzie Health Sciences Centre, Division of Cardiology, University of Alberta, 8440-112 Street, Edmonton, T6G 2B7, Alberta, Canada

    Bodh I. Jugdutt

  2. St. Boniface General Hospital Research C, Institute of Cardiovascular Sciences, Tache Avenue 351, Winnipeg, R2H 2A6, Manitoba, Canada

    Naranjan S. Dhalla

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Singh, K., Brunt, K.R., Weisel, R.D., Li, RK. (2013). Optimizing Stem Cell Therapy for Cardiac Repair Following a Myocardial Infarction. In: Jugdutt, B., Dhalla, N. (eds) Cardiac Remodeling. Advances in Biochemistry in Health and Disease, vol 5. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5930-9_28

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