Cellular cardiomyoplasty: State of the art, evaluation and future possibilities

Cellular cardiomyoplasty or the transplantation of myogenic cells into the myocardial tissues, could emerge as a therapeutic alternative in patients w ith cardiac failure. It depends on several procedures : implantation of cel l types, syngenic embryonic cardiomycocytes, allogenic and autogenic cardia c muscle cells. These cells came into contact with host cardiomyocytes and could contract in a synchronous fashion. Experimental data suggests that this technique could improve global left ve ntricular function in the post-infarction period or in dilated cardiomyopat hy even though the precise mechanism of this improvement is not fully under stood. Many difficulties remain, the cell types have an oncogenic potential ; syngenic foetal cells are weakly immunogenic but their use is limited by ethical and problems of supply. Therefore, auto-transplantation either of c ardiomycocytes obtained by endomyocardial biopsy or of adult skeletal muscl e, could be a potential clinical option.