Predicting the Future With Stem Cells
The best way to predict future is to invent it.
The efficacy of bypass surgery in patients with ischemic cardiomyopathy remains impossible to forecast accurately. In particular, individual variability in factors such as disease comorbidities, genetic background, aging, disease progression, lifestyle, and medications makes the prediction of the outcome of bypass surgery1 a herculean task. Identifying readily available patient-specific information to prognosticate the likelihood of benefit with highly invasive procedures such as bypass surgery not only could minimize patient suffering but also could significantly reduce the cost and resource burdens on a healthcare system that is already stretched to the limit.
Article see p 157
Over the last several years, the cardiovascular field has embraced (with varying degrees of enthusiasm) regenerative medicine. Indeed, expert opinions in the field have ranged from beliefs that stem cells can do virtually anything (eg, repair and replace damaged myocardium) to the notion that they are essentially useless (eg, whatever observed biological effects are functionally meaningless). Despite the ongoing debate, most available evidence now suggests that the heart is a self-renewing organ to some (yet to be clarified) extent and that such reparative processes involve a resident pool of self-replicating and renewing c-kit–positive cardiac stem cells (CSCs).2,3 CSCs have been shown to repair damaged heart after myocardial infarction,4 to contribute to neomyogenesis and angiogenesis,5 and to augment heart function.6 If the functional outcome of bypass surgery depends substantially on the functional competency of CSCs, then forecasting the potential benefit of major surgical interventions such as coronary bypass grafting may be accomplished by preemptively assessing the regenerative potential of the CSC pool. …