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(Circulation Research. 2005;97:99.)
© 2005 American Heart Association, Inc.

Editorials

Beware of Cells Bearing Gifts

Cell Replacement Therapy and Arrhythmic Risk

Samuel C. Dudley, Jr

From the Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Ga; and the Atlanta Veterans Administration Medical Center, Atlanta, Ga.

Correspondence to Dr Samuel C. Dudley, Jr, Division of Cardiology, Emory University/VAMC, 1670 Clairmont Rd (111B), Decatur, GA 30033. E-mail sdudley@emory.edu

See related article, pages 159–167

Key Words: arrhythmia • regenerative medicine • stem cells • electrophysiology • genetic engineering

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Heart failure is a major worldwide health problem that is growing in prevalence despite recent treatment advances. Patients with heart failure ultimately die from either pump failure or cardiac arrhythmia, and there is a link between the degree of contractile dysfunction and arrhythmic risk. Since the 1960s, the definitive therapy for heart failure has been cardiac transplantation, but the limited supply of organs has restricted the impact of this therapy. Starting in the mid-1990s, a series of observations has led to the concept that cells might be used to repair myocardial damage. Subsequently, this therapy has shown promise in ischemic and nonischemic forms of myocardial injury.

	What Is the Right Cell for the Job?

 
The increased availability of cells as compared with organs has driven an exuberant search for the right replacement cells. Nevertheless, after intense study, there is no obvious frontrunner.¹ The concept driving the cell selection process has been the need for a sufficient number of immune compatible, contractile cells. Proposed cell sources have included skeletal myoblasts,² bone marrow–derived progenitor cells,³ and embryonic stem cells.⁴ These 3 cell types have been shown to improve myocardial function in animal models, and the first 2 have shown promise in human clinical trials.⁵ Generally, the effects of these 2 cell types on myocardial function have been similar.⁶

	Cell Replacement Therapy and Arrhythmogenesis

 
If they are to fulfill their promise as replacement myocytes, it is important that the implanted cells functionally couple with the endogenous myocytes to permit coordinated excitation contraction coupling. If replacement cells integrated heterogeneously, have abnormal cellular electrophysiology, or show spontaneous activity, . . . [Full Text of this Article]

Related Article:

Antiarrhythmic Engineering of Skeletal Myoblasts for Cardiac Transplantation

M. Roselle Abraham, Charles A. Henrikson, Leslie Tung, Marvin G. Chang, Miguel Aon, Tian Xue, Ronald A. Li, Brian O’ Rourke, and Eduardo Marbán
Circ. Res. 2005 97: 159-167. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

				H. Q. Ly and S. Nattel Stem Cells Are Not Proarrhythmic: Letting the Genie out of the Bottle Circulation, April 7, 2009; 119(13): 1824 - 1831. [Full Text] [PDF]