Regenerative medicine approach to repair the failing heart

Heart failure is a serious and very common clinical condition in which the heart is about to stop working. Currently, heart failure has no cure. Over the last decade, cardiac cell therapy has been widely studied as a revolutionary approach to promote the non-pharmacological replacement of the lost myocardium. Despite the initial enormous expectations, recent clinical trials have shown modest results without therapeutic effectiveness following cardiac stem cell transplantation. Since the adult heart is not a post-mitotic organ, recent disappointing findings have motivated researchers to pursue alternative therapeutic approaches. New scientific developments on myocardial regeneration derived from studies in animal models have led to the discovery of new naturally occurring molecules that increase the resistance of resident cardiac cells to the ischemic microenvironment and/or promote the self-renewing property of adult myocardium without the transplantation of additional stem cells. Recent evidences have shown that the direct intramyocardial injection of selected chemical compounds in adult beating heart may halt myocardial remodeling and increase cardiac performance in an epigenetic manner. The aim of the present review is to discuss succinctly some important aspects of the new frontiers of regenerative therapy to repair the failing heart. (C) 2013 Elsevier Inc. All rights reserved.