doi: 10.1161/01.CIR.0000132469.85026.46
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(Circulation. 2004;109:2832-2838.)
© 2004 American Heart Association, Inc.
Reviews: Current Perspectives |
Molecular Genetic Advances in Cardiovascular Medicine
Focus on the Myocyte
From the Cardiovascular Research Institute, Department of Medicine, New York Medical College, Valhalla, NY (P.A.); SDSU Heart Institute, San Diego State University, San Diego, Calif (M.A.S.); and the Division of Cardiology, Institute of Molecular Cardiology, University of Louisville, Louisville, Ky (R.B.).
Correspondence to Piero Anversa, MD, Cardiovascular Research Institute, Department of Medicine, New York Medical College, Vosburgh Pavilion Room 302A, Valhalla, NY 10595. E-mail piero_anversa@nymc.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Stem cell homing and engraftment to the heart and new tissue formation capable of replacing the lost myocardium and improving the functional performance of the damaged heart represent the goals of regenerative medicine in cardiac pathophysiology. Theoretically, this outcome can be achieved by using any source of stem cells, embryonic or adult, or other cell types. In fact, several interventions have been used in an attempt to promote myocardial regeneration. These therapeutic strategies have used fetal cardiomyocytes; skeletal myoblasts; embryonic-derived endothelial cells; bone marrow–derived immature myocytes; fibroblasts; smooth muscle cells; endothelial progenitor cells; and hematopoietic, mesenchymal, and embryonic stem cells.1–3 In all cases, promising results have been obtained, and the amelioration in cardiac performance was, at times, coupled with the structural and functional integration of the graft with the host myocardium.4,5 Despite all these efforts, however, the most appropriate form of cellular therapy for myocardial injury remains to be identified, leaving unanswered the key question: What is/are the optimal cell/cells for cardiac repair?
The difficulty encountered in identifying the ideal cell to rebuild the heart is certainly due to the many variables that have to be taken into account, including easy access to the source; the possibility of obtaining a significant number of cells; the time required for the cells to home, grow, and differentiate; and their long-term efficacy. The use of multipotent cells that are not resident in the heart but are derived from other organs such as the bone marrow has raised the problem of transdifferentiation and stem
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