The Role of Cardiac Electrophysiology in Myocardial Regenerative Stem Cell Therapy

Abstract

Recent advances in stem cell biology and tissue engineering have put forth new therapeutic paradigms for treatment of myocardial disease. The aim of stem cell therapy for myocardial regeneration has been directed to induce angiogenesis for ischemic heart disease and/or introduction of new cardiomyocytes to improve the mechanical function of the failing heart. Encouraged by positive preliminary results in mouse models of myocardial infarction, clinical trials have utilized autologous skeletal myoblasts and bone-marrow-derived stem cells to treat patients in various clinical settings including acute myocardial injury, chronic angina, and heart failure. These studies have collectively shown, at best, modest improvement in cardiac function. This may be due to the fact that there is little evidence to support actual formation and/or integration of transplanted cells into the recipient myocardium. More recent and emerging data supports the finding that electrical stimulation may be an effective catalyst for sustained functional organization, integration, and maturation of transplanted cell populations into the host myocardium. A therapeutic model that utilizes electrical stimulation and/or achieves cardiac resynchronization in conjunction with stem cell transplantation may be an effective means to achieve successful myocardial regenerative therapy.

Mesenchymal stem cell surgery, rescue and regeneration in retinitis pigmentosa: clinical and rehabilitative prognostic aspects

“…The enhancement of Cell Surgery by ES has also been observed during muscle reinnervation after sciatic injury using transplanted neurons and myocardial regeneration following ischemic heart failure (Matsumoto et al, 2013). The latter can be explained by the stimulation and production of exosomes that contain cardioprotective molecules (Liu et al, 2012;Matsumoto et al, 2013;Grumbles et al 2013;Huang et al, 2011). In particular, exosomes are useful tools for cell-cell communication in the normal and diseased retina (Campbell et al, 2016;Locke et al, 2014;Atienzar-Aroca et al, 2016) and exert different biological actions depending on their host cell.…”

“…The latter can be explained by the stimulation and production of exosomes that contain cardioprotective molecules ( Liu et al., 2012 ; Matsumoto et al., 2013 ; Grumbles et al. 2013 ; Huang et al., 2011 ). In particular, exosomes are useful tools for cell–cell communication in the normal and diseased retina ( Campbell et al., 2016 ; Locke et al., 2014 ; Atienzar-Aroca et al., 2016 ) and exert different biological actions depending on their host cell.…”

Mimicking Isovolumic Contraction with Combined Electromechanical Stimulation Improves the Development of Engineered Cardiac Constructs

“…Radisic et al initially demonstrated that electrical stimulation induces synchronous contractions, which enhances the conductive and contractile properties of the construct. 16 The general electrical field stimulation induces calcium transients in the cells, which improves the volume fraction and organization of sarcomeres in the tissue 17 and induces alignment of the cells, 18 promoting an increase in gap junction formation and localization. 19 Because of the improvements observed in construct development, electrical stimulation has been used in a number of other studies as a method of developing functional engineered cardiac constructs.…”

Development of Bioartificial Myocardium by Electrostimulation of 3D Collagen Scaffolds Seeded with Stem Cells

“…The association of a multielectrode network for local pacing should improve the coupling of stem cells and scaffolds with host cardiomyocytes, becoming a dynamic tissue engineered support. 18,36 …”