Stem Cell Therapy for Chronic and Advanced Heart Failure
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NONPHARMACOLOGIC THERAPY: SURGERY, VENTRICULAR ASSIST DEVICES, BIVENTRICULAR PACING, AND EXERCISE (A HASAN, SECTION EDITOR)
Stem Cell Therapy for Chronic and Advanced Heart Failure Gregor Poglajen 1,2 & Sabina Frljak 1 & Gregor Zemljič 1 & Andraž Cerar 1 & Renata Okrajšek 1 & Miran Šebeštjen 1 & Bojan Vrtovec 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The purpose of this review is to discuss recent advances in the field of cell therapy in patients with heart failure with reduced ejection fraction (HFrEF) of ischemic (iCMP) and nonischemic (dCMP) etiology, heart failure with preserved ejection fraction (HFpEF), and in advanced heart failure patients undergoing mechanical circulatory support (LVAD). Recent Findings In HFrEF patients (iCMP and dCMP cohorts), autologous and/or allogeneic cell therapy was shown to improve myocardial performance, patients’ functional capacity, and neurohumoral activation. In HFpEF patient population, the concept of cell therapy in novel and remains largely unexplored. However, initial data are very encouraging and suggest at least a similar benefit in improvements of myocardial performance (also diastolic function of the left ventricle), exercise capacity, and neurohumoral activation. Recently, cell therapy was explored in the sickest population of advanced heart failure patients undergoing LVAD support also showing a potential benefit in promoting myocardial reverse remodeling and recovery. Summary In the past decade, several cell therapy-based clinical trials showed promising results in various chronic and advanced heart failure patient cohorts. Future cell treatment strategies should aim for more personalized therapeutic approaches by defining optimal stem cell type or their combination, dose, and delivery method for an individual patient adjusted for patient’s age and stage/duration of heart failure. Keywords Stem cell therapy . Chronic heart failure . Advanced heart failure . LVAD
Introduction Despite significant advances in medical and device therapy were achieved over the past decades, chronic heart failure (CHF) represents an increasingly common and debilitating
disorder worldwide [1]. Even in the current era, CHF carries an unacceptably poor prognosis and is related to prohibitive early and late mortality rates [1]. Although current CHF treatment options have been shown to improve CHF symptoms and signs, to significantly reduce heart failure-related hospital
This article is part of the Topical Collection on Nonpharmacologic Therapy: Surgery, Ventricular Assist Devices, Biventricular Pacing, and Exercise * Gregor Poglajen [email protected]
Miran Šebeštjen [email protected]
Sabina Frljak [email protected] Gregor Zemljič [email protected]
Bojan Vrtovec [email protected]
1
Department of Cardiology, Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia
2
Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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