Abstract

The ability to revive or regenerate severely injured or failing heart muscle is conceptually very attractive as opposed to the largely compensatory and palliative actions of even the best and newest multi-modal medical therapies.

To date, much of the focus of regenerative cardiac therapy has been aimed at introducing new cells in order to add or repopulate functional muscle units. While proof of concept has been largely established, the clinical benefits so far have been quite marginal and the value (benefit/cost) even less. As with any field driven largely by advances in science and technical capabilities, results of one technique may be thought to be largely obsolete by the time they are known.

As the fields of molecular and cellular biology, immunology, cell-signaling, genomics and proteomics continue to each expand and integrate, our understanding of cellular and organ function grows, and incremental advances at the therapeutic edge are made. The future is promising and will continue to advance commensurate with the speed of modern scientific discovery.

This chapter will serve largely as a review of work to date, and data is organized and presented by type of regenerative strategy (cellular vs acellular). Tables and illustrations are organized to aid the reader in gaining a general synthesis of a large body of complex literature over several decades.