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In clinical cellular
cardiomyoplasty, bone marrow cells and myoblasts are introduced mainly to ischemic cardiomyopathy
tissue via several cell delivery systems, such as needle injection or catheter.
These clinical studies have demonstrated the safety and feasibility of this
technique, but its effectiveness for treating heart failure, especially in the
long term, is still under discussion. Neither of these cell types can
differentiate into cardiomyocytes; rather, they improve the failing heart
mainly by the paracrine effects of some cytokines, such as Hepatocyte growth
factor (HGF) and Vascular endothelial growth factor (VEGF). Thus, many
researchers have a great interest in stem cells, which exist in bone marrow,
circulating blood, atrium, and adipose tissue, and can differentiate into cardiomyocytes.
Although several stem cells with the potential to differentiate into various
cell types have been reported, few can differentiate into cardiomyocytes.
Moreover, beating cells that can demonstrate synchronized contraction with
native cardiomyocytes are critical for the complete repair of severe heart
failure. Therefore, stem cells with a high differentiation capacity should be
explored for the goal of completely repairing severely damaged myocardium. In
this review, we summarize the clinical protocols and basic experiments for
cellular cardiomyoplasty using bone marrow cells, myoblasts, and other stem