Essay --

Myocardial infarction is defined as pathological myocardial cell death due to a prolonged interruption of the blood supply to the heart, leading to a permanent loss of cardiomyocytes (Kristian Thygesen et al., 2012). The impact of myocardial infarction brought about a cascade of events followed by scar formation conferring protection to the insulted heart from being ruptured due to high pressure. Although it offers cardiac protection, scar tissues are instead acellular and lack the normal biochemical properties of cardiac cell, thus enhancing the possibilities of disrupting the contractile function of the heart. These then may eventually leads to the depressed left ventricular (LV) systolic and diastolic function of the injured heart (Joggerst & Hatzopoulos, 2009). Heart, has been considered as a terminally differentiated organ with an almost absent self-regenerative capacity back in the early days. The dogma was then broken by the findings documented on the presence of a small cluster of a clonogenic endogenous cardiac stem cell pooling within the heart. These cluster of endogenous cardiac stem cell demonstrates self-renewal capacity and multi-lineage differentiation potential suggesting that heart possess own intrinsic repair mechanism (Antonio P. Beltrami et al., 2003; Bearzi et al., 2007; Ellison, Nadal-Ginard, & Torella, 2012; Koudstaal et al., 2013). However the number of the endogenous cardiac stem cell is too low, rendering the self-repair mechanism to fail (Beltrami et al., 2001). Stem cell based therapy holds promise in participating in the myocardial regeneration replacing the lost functional cardiomyocyte in the damaged myocardium. The roles of bone marrow stem cell transplantation in myocardial therapy too, have long... ... outcome of cardiac therapy. The main idea behind this novel therapeutic approach is the possibility to constrain the limitations of the administration of stem cells in stem cell-based therapy. Taking the advantage of the conditioned medium and the benefit of paracrine signaling factors in promoting endogenous cardiac repair mechanism, we are trying to look at the best culture conditioned in terms of cell seeding density, glucose concentration, serum replacement and incubation time in order to generate conditioned medium that employs a potent paracrine signaling action that might enhance the ex vivo expansion of cardiac stem cell and potentially to be marketed as an ‘off-the-shelf’ cardiac stem cell culture medium in the near future. Yet, more effort should be considered carefully before this novel noninvasive idea is implemented in a more complex clinical setting.