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Acute myocardial infarction (AMI) is a leading cause of death worldwide. (Wollert and Drexler, 2010) Despite improvements in survival rate after AMI with recent medical advances (Jackson, et al., 2001), the reduced heart function attributed to irreversible loss of viable cardiomyocytes remains a major clinical problem (Timmermans, et al., 2003). Typical MI results in large-scale loss of cardiac muscle, often a billion or more myocytes. (Laflamme and Murry, 2005) The loss of myocardial cell mass and the inability of remaining cells to adequately compensate through hypertrophic or hyperplastic responses result in the development of heart failure due to ventricular dysfunction (Jain, et al., 2005). Endogenous repair mechanisms of the adult human heart are not sufficient for meaningful tissue regeneration, so muscle lost is replaced by non-contractile fibrotic scar tissue, initiating progressive heart failure (Laflamme, et al., 2007). Heart failure is the number one cause of hospitalization in US citizens over 65 of age and has a significant economic impact (Laflamme and Murry, 2005). Despite recent advances in treatment options, mortality remains unacceptably high (Ertl, et al., 1993, Pfeffer and Braunwald, 1990, Towbin and Bowles, 2002) with >50% of all patients succumbing within 5 years of the initial diagnosis of heart failure (Jain, et al., 2005). Improved medical and surgical treatments for patients after AMI have led to the decrease in early mortality, but as a result there of a higher incidence of heart feailure. (Wollert and Drexler, 2010) In some patients with advanced disease, cardiac transplantation may be an option, but due to organ shortage, its practical use is limited to end-stage heart failure. In the current clinical setting, early reperfusion by percutaneous coronary intervention (PCI) including intra-coronary stenting is the treatment of choice in the situation of acute MI (Topol, 2003). In patients with diffused coronary artery disease associated with severe ischemic cardiomyopathy, coronary artery bypass grafting (CABG) remains the optimal way of coronary revascularization, and is associated with improved survival and reduction of angina (Detre, et al., 1996, Pell, et al., 2004). Although surgical and catheter-based revascularization of ischemic myocardium can treat angina, reduce the risk of MI, and

Autologous Stem Cells for Cardiac Repair: New Insights on Clinical Trial Safety and Best Cell Source