Abstract

The heart is one of the most industrious organs in the human body. It starts beating in the first few weeks of embryonic life and keeps pumping blood till death. This organ can host a range of diseases as well. Some can hamper the vasculature, while others can affect its electrical activity, the heart valves, etc. All these conditions can lead to end-stage failure where it can no longer meet the requirements of the body’s milieu. This imbalance between supply and demand leads to an array of symptoms. Medical management can reduce these clinical effects and possibly prolong the life expectancy in such patients. However, prescription medications can also have their own adverse effects. This necessitates that each line of treatment should be assessed on a risk vs benefit basis. The conventional approach has been to try and slow down the progression of heart failure (HF). However, the inception of stem cells in the management of HF has the potential for reversal of this pathology. Keeping this in view, many studies and trials are under process. To turn the clock back on the HF, before complications set in or get out of control, is the main focus of the time. This article attempts to evaluate various studies about stem cell therapy (SCT) and highlight the important aspects of this novel modality in changing patients' lives.

Highlights

  • BackgroundThe heart is the first functional organ to develop in the human body, and it continues to perform its work as long as a person lives

  • heart failure (HF) implies that the heart is not pumping well enough for normal body functioning, which may have a negative impact on the other organs

  • Stem cells were delivered to the subepicardial areas of the patients in the experimental group. It showed an increase in left ventricular ejection fraction (LVEF) from a pretreatment value of 29.4% of normal to 46.1% in the patients with ischemic HF receiving autologous stem cell therapy (SCT) plus coronary artery bypass grafting (CABG), as opposed to an increase from 30.7% to 37.2% in the control group that received only CABG

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Summary

Introduction

The heart is the first functional organ to develop in the human body, and it continues to perform its work as long as a person lives. SCT was associated with lower vascular endothelial growth factor (VEGF) levels, compared to autologous stem cells (P = 0.0012) Based on these findings, this study confidently asserts the advantageous effects of allogeneic MSCs on endothelial cells despite the sample size and matching limitations. A phase 3 RCT titled " The Effect of Intracoronary Infusion of Bone Marrow-derived Mononuclear Cells on All-cause Mortality in Acute Myocardial Infarction: Rationale and Design of the BAMI Trial" has been initiated at an international level The results of this RCT indicate that the patients with low LVEF (less than or equal to 45%), who had previously undergone reperfusion successfully after acute MI, showed a decrease in mortality after receiving autologous bone marrow MNCs in comparison to the patients that received standard medical treatment only [38]. This article urges a need for personalized treatment regimes

Conclusions
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22. Janssens S

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