Regenerative Principles Enrich Cardiac Rehabilitation Practice

Atta Behfar, Andre Terzic, Carmen M. Perez-Terzic
2014 American Journal of Physical Medicine & Rehabilitation  
Cardiovascular morbidity imposes a high degree of disability and mortality, with limited therapeutic options available in end-stage disease. Integral to standard-of-care, cardiac rehabilitation aims on improving quality of life and prolonging survival. The recent advent of regenerative technologies paves the way for a transformative era in rehabilitation medicine whereby, beyond controlling risk factors and disease progression, the prospect of curative solutions is increasingly tangible. To
more » ... , the spectrum of clinical experience in cardiac regenerative medicine relies on stem cell-based therapies delivered to the diseased myocardium either acutely/subacutely, following a coronary event, or in the setting of chronic heart failure. Application of autologous/allogeneic stem cell platforms has established safety and feasibility, with encouraging signals of efficacy. Newer protocols aim to purify cell populations in an attempt to eliminate non-regenerative and enrich for regenerative cell types prior to use. Most advanced technologies have been developed to isolate resident cell populations directly from the heart, or alternatively condition cells from non-cardiac sources to attain a disease targeted lineage-specified phenotype for optimized outcome. As a multiplicity of cell-based technologies has undergone Phase I/II evaluation, pivotal trials are currently underway in larger patient populations. Translation of regenerative principles into clinical practice will increasingly involve rehabilitation providers across the continuum of patient care. Regenerative rehabilitation is thus an emerging multidisciplinary field, full of opportunities and ready to be explored. "We cannot solve problems with the same thinking that we used when we created them." Albert Einstein NIH Public Access
doi:10.1097/phm.0000000000000147 pmid:25313663 pmcid:PMC4197403 fatcat:ejzc6owdjfdtxltswwgdljs2wy