Abstract
In this review, we focus on new approaches that could lead to the regeneration of heart muscle and the restoration of cardiac muscle function derived from newly-formed cardiomyocytes. Various strategies for the production of cardiomyocytes from embryonic stem cells, induced pluripotent stem cells, adult bone marrow stem cells and cardiac spheres from human heart biopsies are described. Pathological conditions which lead to atherosclerosis and coronary artery disease often are followed by myocardial infarction causing myocardial cell death. After cell death, there is very little self-regeneration of the cardiac muscle tissue, which is replaced by non-contractile connective tissue, thus weakening the ability of the heart muscle to contract fully and leading to heart failure. A number of experimental research approaches to stimulate heart muscle regeneration with the hope of regaining normal or near normal heart function in the damaged heart muscle have been attempted. Some of these very interesting studies have used a variety of stem cell types in combination with potential cardiogenic differentiation factors in an attempt to promote differentiation of new cardiac muscle for possible future use in the clinical treatment of patients who have suffered heart muscle damage from acute myocardial infarctions or related cardiovascular diseases. Although progress has been made in recent years relative to promoting the differentiation of cardiac muscle tissue from non-muscle cells, much work remains to be done for this technology to be used routinely in translational clinical medicine to treat patients with damaged heart muscle tissue and return such individuals to pre-heart-attack activity levels.
Highlights
Atherosclerosis is a pathological condition resulting in the narrowing of blood vessels due to an accumulation of atherosclerotic plaques between the smooth muscle and endothelial layer leading to acute myocardial infarction with major damage to the cardiac muscle and even death to the individual
LDL (Low-density lipoprotein) accumulation in blood vessels that can be associated with age-related diseases such as diabetes are thought to be a primary step in the origin of atherosclerosis
Blood platelets can attach to the atherosclerotic plaques creating a blood clot that blocks or severely reduces the blood supply to, for example, the heart muscle and without blood, the myocardium is deprived of oxygen causing damage or death to the cardiac cells
Summary
Atherosclerosis is a pathological condition resulting in the narrowing of blood vessels due to an accumulation of atherosclerotic plaques between the smooth muscle and endothelial layer leading to acute myocardial infarction with major damage to the cardiac muscle and even death to the individual. These plaques consist of lipids, calcium deposits, cellular debris and so-called foam cells. A major problem in heart regeneration after a myocardial infarction is that cardiomyocytes die and are replaced by non-contracting fibrous scar tissue rather than new cardiac muscle cells This supports function of the damaged heart temporarily, but in the long term, it weakens the organ’s ability to contract normally and increases the risk of a further heart attack.
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