Heart failure (HF) is a leading cause of mortality worldwide and a major problem of global health causing around 5% of the

acute hospital
admissions and accounting for around 10% of hospitalized patients in Europe and the United States. In Indonesia, heart failure

Coronary Heart Disease is known as one of major global health care problem.
Recent advance of myocardial infarct therapy still not able to reduce incidence,
hospitalization, and mortality. One of notable event following myocardial infarct is heart
remodeling. Numerous of study showed stem cell potential to repair heart tissue after acute
myocardial infarction. Induced pluripotent stem cell (iPSC) is one of potential candidate of
stem cell resource for heart failure therapy post myocardial infarction

Myocardial infarction is still leading cause of congestive heart failure and death in many countries. The percentage
of death is 5,1%. This disease may cause progressive and irreversible myocardial damage. Because of that,
conventional therapy like reperfusion, won’t overcome it completely. So, in this era, we need therapy that could
regenerate them. This therapy could be done by applying stem cell clinically, as an answer of the hope to
regenerate irreversible cell damage. Stem cell could regenerate other cells by cells differentiation and secretion
cytokine also other growth factors. Bone marrow derived stem cells remain the most commonly used cell type for
human studies. It has the feasibily of procuring, no requirement of in vitro expansion, and above all the availability
of mixed populations of cells with characteristic for differentiating into various populations of cells. The most
appropriate utilized method of stem cell delivery is the transvascular approach. It is stated by many studies before,
in which resulted improvement of function and anatomical structure of cardiac, above beyond other conventional
therapy. Thus, another study still needed to be done, in order to optimalize stem cell therapy in the future.

The study of stem ceel therapy in the world has grown rapidly in the last fe decade, especially in cardiovascular disease such as acute myocardial
infarction, end stage coronary heart disease and cardiomyopathy. In the future, stem cell therapy is considered as the ultimate limit treatment of
various disease. Therefore, the development of stem cell therapy is expected to meet the challenges in the treatment of various diseases. Indonesia
is one of the pioneers of stem cell therapy in acute myocardial infarction in Southeast Asia and is one of the first countries in Asia other than
Hongkong usiang Noga tool for mapping and injecting stem cells in the heart muscle through a catheterization on final stage coronary heart
disease.
Stem cells, including embryonic stem cell (ESC), cardiac stem cells (CSCS) and induced pluripotent stem cell (IPSS) can undergo differentiation
into cardimyocytes and restore the function of the heart contractions. These cells can also differentiate into endothelial cells, triggering the
formation of new blood vessels (angiogenesis), patially rstore damaged heart muscle cells to stay alive and block the expansion of scar tissue.
Other mechanisms in cardiac stem cells therapy that is currently widely adopted is through paracrine effects. There are several methods of
administration of stem cells in the heart that intracoronary, epikardial and intravenously.
Research in the field of cardiovascular regenerative medicine regarding stem cell therapy will continue to grow in the future, including about
types of cells and stem cells best giving technique.

therapeutic approach of chronic heart failure by using pharmacotherapy and heart devices still can not
decrease morbidity and mortality satisfactorily. More promising therapies are needed to overcome this
problem. One of them is the stem cell therapy. There are several kinds of selected stem cells: myoblasts,
bone marrow and blood cells, and umbilical cord blood cells. All of these have their own benefits and
limitations. The effective and safe procedure mostly chosen for transplantation is intracoronary infusion,
using a standard balloon catether. In this case, stem cells are directly transplanted to the myocardium
where the blood and oxygen supply can be maintained. Although stem cell therapy has brought a
highlight in the therapeutic approach, there are still many things to be concerned about, e.g. the most
suitable kind of cell for myocardium repairment, the suitable procedure, the right time to do the
transplant, the given dose, and the morbidity and survival rates.