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Cardiovascular Research 2003 58(2):358-368; doi:10.1016/S0008-6363(02)00739-3
© 2003 by European Society of Cardiology
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Copyright © 2003, European Society of Cardiology

Cellular cardiomyoplasty—cardiomyocytes, skeletal myoblasts, or stem cells for regenerating myocardium and treatment of heart failure?

Thorsten Reffelmann and Robert A. Kloner*

The Heart Institute, Good Samaritan Hospital, Cardiovascular Division, University of Southern California, 1225 Wilshire Boulevard, Los Angeles, CA 90017-2395, USA

* Corresponding author. Tel.: +1-213-977-4050; fax: +1-213-977-4107. rkloner@goodsam.org

Received 20 August 2002; accepted 18 October 2002

The first 150 words of the full text of this article appear below.


    1 Introduction
 
In newts, excision of up to 50% of the ventricular myocardium results in spontaneous regeneration and rebuilding of the heart, a process that involves de-differentiation of the remaining cardiomyocytes, de-novo synthesis of DNA followed by proliferation and mitotic cell division of both cardiomyocytes and connective tissue, and subsequent replacing of the lost tissue [1–3]. In contrast, the mammalian heart loses its capability of a quantitatively sufficient proliferative response to various injuries soon after birth [4–6]. Interestingly, recent studies reported a certain degree of cardiomyocyte regeneration in various pathologic conditions, such as heart failure [7], orthotopic heart transplantation [8,9], or myocardial infarction [10,11], and even surmised the existence of resident cardiac stem cells [12], or extracardiac cardiomyocyte progenitor cells [13] in the mammalian heart. However, these findings are still controversial [14]. In some of these studies, the presence of the Y-chromosome in hearts from . . . [Full Text of this Article]


    2 Fetal and neonatal cardiomyocytes—what can be achieved?
 
2.1 Six months, and still alive
2.2 Early declining proliferative activity
2.3 Incomplete differentiation and integration
2.4 Do they contract?
2.5 Translation into clinical practice?

    3 Skeletal myoblasts—substitute for loss of cardiomyocytes with higher availability?
 

    4 Stem cells—an alternative source for cellular cardiomyoplasty?
 
4.1 Embryonic stem cells
4.2 Bone marrow derived mesenchymal stem cells

    5 How to improve the results
 
5.1 The technique of transplantation
5.2 Tissue processing and culturing technique
5.3 Simultaneous gene therapy with cardiomyoplasty?

    6 Conclusions and summary
 

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