Adipose Tissue-Derived Mesenchymal Stem Cell and Angiogenesis in Ischemic Heart Disease

Acute myocardial infarction is one of the most important causes of death and disability worldwide. The limited capacity of the adult heart to self-regenerate and revascularize the ischemic damaged tissue leads to tissue loss, ventricular remodeling, and persistent deterioration in cardiac performance increasing the frequency of heart failure. Over the last several years, adult stem cells have appeared as one of the novel promising therapeutic approaches for the treatment of ischemic heart disease. However, the quest for the best cell type is still ongoing. This ideal cell type should be capable of differentiating into functional cardiomyocytes and of forming new vessels to nourish the damaged area. Recent studies have shown that adipose tissue contains multipotent stem cells (the so-called adipose tissue-derived stem cells or ASC) that are capable of regenerating injured myocardium by differentiating into cardiac resident cells or by secreting multiple angiogenic growth factors (paracrine effects). Moreover, due to ease of harvesting these cells in large numbers and low immunogenicity, white adipose tissue has become an attractive stem cell source. In this chapter, we review the principal characteristics of ASC as well as their capacity to repair cardiac damage in the setting of ischemic heart disease as compared with other adult stem cells, with special attention to their pro-­angiogenic mechanisms of action.