Stem cell therapy for the infarcted heart ("cellular cardiomyoplasty").

BACKGROUND: Myocardial infarction is the leading cause of heart failure in developed countries, because even the advanced therapeutic measures of today are usually not sufficient to prevent left ventricular remodeling as they fall short of actual replacement of necrotic cardiac myocytes. Recent new insights into stem cell biology have changed our understanding of regenerative activities in the infarcted heart and have raised considerable hopes for novel therapeutic approaches aimed at cardiac myocyte replacement/regeneration through cell transplantation ("cellular cardiomyoplasty"). CELL-BASED THERAPEUTIC CONCEPTS: This review summarizes our present understanding of physiological stem cell/precursor cell mobilization to the infarcted heart and discusses the main therapeutic concepts for cell-based regeneration of myocardial infarction (adult/embryonic stem cells, skeletal myoblasts, endothelial precursors and others), including a brief overview of ongoing clinical trials. Finally, a shortlist of central clinical and research goals is provided, which should be addressed by stringently designed patient trials.