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J Thorac Cardiovasc Surg 2002;123:584-585
© 2002 The American Association for Thoracic Surgery

Letters to the Editor

Cell transplantation, ventricular remodeling, and the extracellular matrix

Division of Cardiac Surgery
University of Toronto
Toronto General Hospital
200 Elizabeth St, EN 14-215
Toronto, Ontario M5G 2C4, Canada

Reply to the Editor:

We appreciate the interest expressed by Gorman and Gorman with respect to cell transplantation. They have raised an important issue about the mechanism of the beneficial effects achieved in animal studies and clinical trials. In our editorial "Cell Transplantation Comes of Age," we suggested that cell transplantation stabilizes the infarct region, induces angiogenesis, and modifies the response of the remaining myocardium to the infarct. The beneficial effects of cell transplantation are the result of a profound biologic response to cell engraftment that influences both regional and global remodeling of the heart. Therefore, we believe cell transplantation is a targeted therapy for myocardial remodeling, not a haphazard replacement of lost cells. A biologic approach to patients at risk of congestive heart failure may be more effective than mechanical restraint in preventing infarct expansion and ventricular dilatation. However, the combination of a biologic and mechanical intervention may prove to be the most effective approach to prevent heart failure. We will review our evolving understanding of the possible mechanisms of cell transplantation on both regional and global left ventricular remodeling.

As . . . [Full Text of this Article]

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