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Hopefully the BAMI Trial will avoid the important variables that have been described in this paper and will provide definitive answers to the questions whether BMCs can significantly decrease patient mortality due to myocardial infarction, substantially reduce infarct size and increase LVEF over three years in comparison with patients treated with best medical therapy. CARDIAC STEM CELLS Cardiovascular investigators have sought alternatives to BMCs for cardiac repair in patients with ischemic heart disease. Cardiac stem cells, this website which are multipotent progenitor cells, are present in niches in the heart and contribute to the physiological turnover of myocytes and vascular endothelial cells in the heart. The number of cardiac stem cells in the heart is estimated at one cardiac stem cell per 10000 cardiac myocytes[258]. Consequently, endogenous cardiac stem cells are not normally able to reverse heart damage due to myocardial infarctions. The turnover of cardiac myocytes occurs at rates estimated to be 1% to as much as 22% per year and is dependent on the age, sex, and the health of the individual[259,260]. Two major types of autologous cardiac stem cells have been investigated in patients with injured and infarcted myocardium Mianserin HCl in the SCIPIO and CADUCEUS clinical trials: C-kit + lineage negative cardiac stem cells isolated from right atrial appendages and cardiosphere derived cells (CDCs) grown from right ventricular cardiac muscle biopsies. C-KIT + STEM CELLS C-kit is a receptor for stem cell factor, which is released from the ischemic myocardium, and is important in the chemoattraction of stem cells to apoptotic, injured and necrotic myocardium. C-kit + stem cells have the capacity for self-renewal, clonogenicity and multi-potency[261,262]. These stem cells can express the cardiac transcription factors GATA-4, Nkx2.5 and MEF2 and can differentiate into myogenic, vascular endothelial and smooth muscles cells in-vitro[261,262]. In research animals with AMIs, cardiac stem cells can form new myocardium[262]. SCR7 in vitro Autologous C-kit cardiac stem cells from right atrial appendages have recently been used for the treatment of patients with myocardial infarctions and ischemic cardiomyopathies in the open labeled Cardiac Stem Cell Infusion in Patients with Ischemic Cardiomyopathy (SCIPIO) Trial[263-265]. In this trial C-kit positive stem cells were isolated during coronary artery bypass surgery from the right atrial appendages of patients with LVEFs