Mechanisms Contributing to the Progression of Ischemic and Nonischemic Dilated Cardiomyopathy

Abstract 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...

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Published in:Journal of the American College of Cardiology 2015-11, Vol.66 (18), p.2038-2047
Main Authors: Kelkar, Anita A., MD, MPH, Butler, Javed, MD, MPH, Schelbert, Erik B., MD, MS, Greene, Stephen J., MD, Quyyumi, Arshed A., MD, Bonow, Robert O., MD, Cohen, Ira, MD, PhD, Gheorghiade, Mihai, MD, Lipinski, Michael J., MD, Sun, Wei, PhD, Luger, Dror, PhD, Epstein, Stephen E., MD
Format: Article
Language:English
Subjects:
cardiac
Cardiology
Cardiomyopathy
Cardiovascular
Cardiovascular disease
cell- and tissue-based therapy
Coronary vessels
extracellular matrix
Heart attacks
heart failure
inflammation
Internal Medicine
Mortality
myocardium
myocytes
paracrine mechanisms
Patients
Stem cells
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cited_by cdi_FETCH-LOGICAL-c2720-c8a94a101e47654dffd4b5092f3bea8cc76caec38b67bf15cfc6be5b606391d53
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creator Kelkar, Anita A., MD, MPH
Butler, Javed, MD, MPH
Schelbert, Erik B., MD, MS
Greene, Stephen J., MD
Quyyumi, Arshed A., MD
Bonow, Robert O., MD
Cohen, Ira, MD, PhD
Gheorghiade, Mihai, MD
Lipinski, Michael J., MD
Sun, Wei, PhD
Luger, Dror, PhD
Epstein, Stephen E., MD
description Abstract 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.
doi_str_mv 10.1016/j.jacc.2015.09.010
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subjects cardiac
Cardiology
Cardiomyopathy
Cardiovascular
Cardiovascular disease
cell- and tissue-based therapy
Coronary vessels
extracellular matrix
Heart attacks
heart failure
inflammation
Internal Medicine
Mortality
myocardium
myocytes
paracrine mechanisms
Patients
Stem cells
title Mechanisms Contributing to the Progression of Ischemic and Nonischemic Dilated Cardiomyopathy
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