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Updated: Aug 8, 2026
Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model
Published on: September 3, 2020
[Stem cells after myocardial infarction]
Volker Schächinger1, Stefanie Dimmeler, Andreas M Zeiher
1Medizinische Klinik III/Kardiologie, J.W.-Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt. schaechinger@em.uni-frankfurt.de
Insights
Transplanting progenitor cells after myocardial infarction improves heart function and vascularization. Larger trials are needed to confirm effects on mortality and morbidity.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
- Stem Cell Therapy
Background:
- Myocardial infarction leads to left ventricular remodeling and heart failure.
- Regenerating cardiomyocytes and improving neovascularization are key therapeutic goals.
- Adult stem and progenitor cells show promise in preclinical models.
Purpose of the Study:
- To evaluate the therapeutic potential of progenitor cell transplantation after myocardial infarction.
- To assess the safety and efficacy of intracoronary progenitor cell infusion.
- To investigate the impact on left ventricular function, geometry, and vascularization.
Main Methods:
- Intracoronary transplantation of adult progenitor cells (e.g., CPCs).
- Assessment of left ventricular function, geometry, and vascularization post-transplantation.
- Clinical trials including randomized, placebo-controlled studies (e.g., REPAIR-AMI).
Main Results:
- Progenitor cell transplantation is feasible and safe in acute myocardial infarction patients.
- Significant improvements in left ventricular function, geometry, and vascularization observed.
- The REPAIR-AMI trial showed significant LV function improvement in treated patients.
Conclusions:
- Intracoronary progenitor cell infusion is a promising strategy post-myocardial infarction.
- Further large-scale, randomized trials are warranted to confirm effects on mortality and morbidity.
- Validated progenitor cell processing is crucial for therapeutic efficacy.
Abstract:
Loss of contractile myocardial tissue after myocardial infarction is followed by a remodeling of the left ventricle and clinical manifestation of heart failure, associated with a reduced life expectancy. One possibility to counteract the remodeling process would be to regenerate cardiomyocytes and to improve neovascularization in the infarct area. Indeed, experimental studies demonstrate that transplantation of adult stem or progenitor cells such as circulating, endothelial progenitor cells (CPCs) or progenitor cells derived from the bone marrow, is a therapeutic strategy to improve neovascularization and left ventricular (LV) function after myocardial infarction. First clinical trials in patients after an acute myocardial infarction indicate that intracoronary transplantation of adult progenitor cells is feasible and safe. Furthermore, patients treated with progenitor cells experienced an unexpectedly large improvement of LV function and geometry as well as vascularization, indicating a beneficial effect of the progenitor cell treatment on the postinfarction course. Randomized trials have obtained mixed results with respect to improvement of LV function after intracoronary infusion of progenitor cells, which may be due to methodological differences. However, in the largest trial, REPAIR-AMI, LV function significantly improved in progenitor cell-treated patients compared to a double-blind, randomized placebo-control group. Of note, that trial used a previously validated processing of progenitor cells with respect to in vitro and in vivo progenitor capacity of the cells. The data available, therefore, encourage assessing the efficacy of intracoronary infusion of progenitor cells-established to be efficient in previous trials-after acute myocardial infarction in larger, randomized controlled trials in order to assess the effect on mortality and morbidity.
