ISSN: 1755-5310 (Electronic)1755-5302 (Print)

Interventional Cardiology

Heart Regeneration Top Open Access Journals

Cardiac regeneration requires new cardiomyocytes. Three scenarios can be envisioned today to increase the number of cardiomyocytes in an injured heart. (i) Fibroblasts, amply abundant in infarct scars, can be reprogrammed in situ into cardiomyocytes (“direct reprogramming”). (ii) The low rate of endogenous cardiac regeneration can be stimulated. (iii) Cardiomyocytes can be generated in vitro and transplanted into or onto the injured heart. The only cell source that undisputedly gives rise to relevant numbers of human cardiomyocytes in vitro are human pluripotent stem cells i.e. human embryonic stem cells (hESC), human induced pluripotent stem cells (hiPSC), human parthenogenetic stem cells (hPGSC) and human nuclear transfer-mediated ESC (hNT-ESC).Cardiac regeneration in zebrafish and newborn mice appears to involve mainly proliferation of existing cardiomyocytes. Genetic fate mapping experiments in adult mice reached diverging conclusions. An early study reported that cardiomyocytes remained essentially stable during normal aging in mice, but that myocardialinfarction led to the formation of new cardiomyocytes from a non-cardiac (= non-α-myosin heavy chain-positive) population of progenitor cells. In contrast, more recent studies including one of the same groups concluded that progenitors contribute little or none to the low renewal rate of cardiomyocytes in adult mammals, consistent with the zebrafish data showing that cardiomyocytes can re-enter the cell cycle, albeit at low rate.    

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