The ultimate goal of cardiac repair is to regenerate functionally viable myocardium after myocardial infarction (MI) to prevent or heal heart failure.This review provides a comprehensive overview of treatment with stem-like cells in preclinical and clinical studies to assess the feasibility and efficacy of this novel therapeutic strategy in ischaemic cardiomyopathy.Conventional surgical interventions, such as coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), are only able to restore heart function to a minor degree, with an improvement in the left ventricular ejection fraction (LVEF) of only approximately 3-4% .Stem cell therapy has emerged as a promising strategy for the treatment of dead myocardium, directly or indirectly, and seems to offer functional benefits to patients .
Coculture of SKMs and neonatal cardiac myocytes in intercalated discs induced transdifferentiation into cardiomyocytes that expressed the cardiac-specific markers GATA4 and Nkx2.5 together with N-cadherin and connexin 43 [36, 37].
The overall efficacy for BMCs from meta-analysis on multiple published data has been inconsistent but relatively modest, with an improvement in LVEF of approximately 3-4% .
The majority of BMCs data for therapy, however, is less than ideal due to the limited component of active undifferentiated stem cells existing in bone marrow from early studies .
Currently, remarkable progress has been made to demonstrate the presence of cycling cardiomyocytes in humans [5–7].
Radiocarbon birth dating has suggested that turnover rate in the endogenous adult human heart is approximately 1% per year, with approximately 45% of cardiomyocytes predicted to be renewed after birth .