The proarrhythmic risk of cell therapy for cardiovascular diseases

Abstract

Stem cell therapy is an emerging therapeutic approach for the treatment of cardiovascular diseases. Experimental studies have demonstrated that different types of stem cells, including bone marrow-derived cells, mesenchymal stem cells, skeletal myoblasts, and cardiac progenitor cells and embryonic stem cells, can improve cardiac function after myocardial injuries. Nevertheless, the potential proarrhythmic risk after stem cell transplantation remains a major concern. Several mechanisms, including the immaturity of electrical phenotypes of the transplanted cardiomyocytes, poor cell–cell coupling and cardiac nerve sprouting, may contribute to arrhythmogenic risk after stem cell transplantation. This review summarizes the potential theoretical arrhythmogenic mechanisms associated with different types of stem cells for the treatment of cardiovascular diseases. Nevertheless, current experimental and clinical data on the proarrhythmic risk for different types of stem cell transplantation are limited, and await further experimental and clinical investigation.

Keywords::

• cardiac regeneration
• cardiovascular diseases
• proarrhythmia
• stem cell
• transplantation

Financial & competing interests disclosure

This study was supported by the Research Grants Council of Hong Kong General Research Fund (grant no. HKU 7594/05M, HKU 7769/08M); the Outstanding Researcher Award 2007–2008 (H-F Tse); and the Collaborative Research Fund of Hong Kong Research Grant Council (HKU 8/CRF/09). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.