Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration

Abstract

The incidence of severe ischemic heart disease caused by coronary obstruction has progressively increased. Alternative forms of treatment have been studied in an attempt to regenerate myocardial tissue, induce angiogenesis, and improve clinical conditions. In this context, cell therapy has emerged as a promising alternative using cells with regenerative potential, focusing on the release of paracrine and autocrine factors that contribute to cell survival, angiogenesis, and tissue remodeling. Evidence of the safety, feasibility, and potential effectiveness of cell therapy has emerged from several clinical trials using different lineages of adult stem cells. The clinical benefit, however, is not yet well established. In this review, we discuss the therapeutic potential of cell therapy in terms of regenerative and angiogenic capacity after myocardial ischemia. In addition, we addressed nonpharmacological interventions that may influence this therapeutic practice, such as diet and physical training. This review brings together current data on pharmacological and nonpharmacological approaches to improve cell homing and cardiac repair.

Adipose Tissue-Derived Stem Cells in Regenerative Medicine

“…In recent years, cell therapies for cardiovascular and myocardial tissue regeneration have been an area of large interest. A variety of cell types have been shown to have a beneficial effect, especially for regeneration of the ischemic myocardium [35]. The paracrine factors can improve cardiac function by reducing the apoptosis of cardiomyocytes or by activating cardiac stem cells to increase cardiomyogenesis [36].…”

Depression and quality of life in patients with chronic heart failure

“…Významným prvkem je také edukace týkající se CHSS, jeho příznaků, managementu a komplikací (3, 21). Velmi důležitou u pacientů s CHSS je fyzická aktivita prokazatelně zvyšující kvalitu života (21,12,22). Pravidelná aktivita, jako je chůze nebo jíz-da na kole je pro pacienty se stabilizovaným srdečním selháním bezpečná, zvyšuje zátěžovou kapacitu (23,12) a snižuje počet hospitalizací (24).…”

“…Součástí celého rehabilitačního programu je nutnost dodržovat další režimová opatření (psychická pohoda, kontrola krevního tlaku, kontrola lipidů a cukru v krvi, zanechání kouření aj.) (21,22). Kvalitu života pacientů s CHSS významně narušuje deprese.…”

Therapeutic targeting of autophagy in myocardial infarction and heart failure

“…Hence, some of the strategies to improve the regenerative potential of the human heart upon MI include activating the growth response of resident progenitor cells, promoting the homing of exogenous stem cells to the injured myocardium, increasing the number of mitotic cardiac cells by stem cell therapy, and preventing pathological cardiac tissue remodeling that favors CHF [85,86]. In the following sections, we will summarize the approaches employed to use autophagy as a strategy to promote cardiac regeneration and prevent the progression of CHF following MI.…”