Autologous Bone Marrow Stem Cell Transplantation In Acute Myocardial Infarction Basic And Clinical Research

BackgroundsProlonged interruption of myocardial blood flow initiates events that culminate in cardiac myocyte death . Proposed endogenous reparative mechanisms include cardiac myocyte hypertrophy and hyperplasia and the trafficking of bone marrow-derived stem cells (BMCs) to the myocardium for repair and angiogenesis None of these proposed mechanisms are adequate in restoring lost myocardium or sustaining cardiac function. The myocardial damage and subsequent neurohormonal activation-induced remodeling causes significant morbidity years later in the form of heart failure. Chronic heart failure (CHF) is a leading cause of hospitalization and associated with a poor prognosis, although in the past decadeS substantial progress has been made in understanding the pathophysiology and therapy of CHF with reduced left ventricular ejection fraction(LVEF). Use of angiotensin-converting-enzyme inhibitors and angiotensin-receptor antagonists either individually or in combination, certain beta-receptor blockers, and judicious use of aldosterone antagonists, has reduced hospital admission rates and mortality from CHF with reduced LVEF. Yet, morbidity and mortality remain high, indicating a major need for further improvement. Prevention of apoptosis and particularly regeneration of cardiac muscle would represent a shift of the current paradigm.Mesenchymal stem cells (MSCs) are self-renewing, clonal precursors of...