Affiliation:
1. MedStar Georgetown University Hospital
Abstract
Despite the use of pharmacological therapies, the morbidity and mortality of cardiac diseases remain high. This paper aims to review multiple promising therapies and highlight the innovative role that stem cells can play. Stem cells have been identified as a potential therapeutic alternative to current mainstay medical and surgical interventions for cardiac pathologies, as these cells possess multipotent capabilities that could aid in cardiac regeneration and remodeling without the detriment of scar tissue. Numerous studies have explored the preliminary safety and efficacy of stem cell treatments in cardiac diseases, specifically ischemic heart disease (IHD), congenital heart disease (CHD), and dilated cardiomyopathy (DCM). IHD studies utilized intracoronary and intramyocardial delivery of various stem cell types and found efficacy with intramyocardial delivery of autologous mesenchymal stem cells injected into infarcted cardiac tissue. Similarly, CHD studies utilized intracoronary delivery of cardiosphere-derived cells in conjunction with the well-established Norwood Procedure and found benefits in cardiac function and somatic cell growth. DCM studies in murine models and subsequent clinical trials showed that transplantation with CD34+ stem cells, a cell type marked by muscle satellite cells, improved cardiac function and increased exercise capacity when delivered via intracoronary or transendocardial transplantation methods. While these cumulative results show promise, longer follow-ups and larger sample sizes are needed to validate the efficacy of this therapeutic approach for cardiac diseases in the long term. Stem cells, when combined with existing therapies, have the potential to mitigate the grave morbidity and mortality associated with cardiac pathologies.
Publisher
Georgetown University School of Medicine