[Current practice and future perspectives of myocardial stem cell therapy]

Myocardial infarction became more frequent mainly in the developed countries in the past decades. Beside the pharmacological (thrombolysis, beta-blockers, ACE-inhibitors, antiplatelet- and lipid-lowering drugs, etc.) and interventional (percutaneous coronary intervention, intraaortic balloon pump, resynchronization therapy, left ventricular assist devices etc.) procedures the quality of life of patients and the morbidity and mortality data were improved. However we experience development of heart failure following myocardial infarction because of significant cell loss and left ventricular remodeling. Until now there was not any therapeutic procedure affecting via cardiomyocyte renewal, but in the last 5 years the myocardial stem cell therapy was introduced to human clinical phase. In this review the authors summarized the general features of stem cells, why these cells are in the focus of the interest and their preclinical and clinical applications in myocardial infarction. Promising issues suggests, that intramyocardial implantation of autologous bone marrow derived stem cells become a new therapeutic modality in treatment of myocardial infarction. The stem cell therapy and regenerative medicine would open new perspectives in cardiology. However it is very important to remark, that this, as every medical procedure can be dangerous and can cause side effects. A lot of molecular and cellular mechanism of cell therapy is not clear at present, that's why we should be careful with this opportunity holding in our hands. We have to plan multicenter clinical trials to evaluate the long term safety and efficacy of the procedure.