Heart disease is a major cause of death worldwide, and the leading cause of death in the United States. The most common type of cardiac disease, coronary heart disease, often results in heart attacks and accounts for nearly 380,000 annual deaths. Despite such high mortality rates, survival and recovery from a heart attack is very much possible, and new research continues to provide hope for the advancement of clinical methods supporting cardiac restoration after a heart attack.
During a heart attack, ischemia (the loss of adequate blood supply to the heart) causes cardiomyocytes (cardiac muscle cells) to be irreversibly destroyed. Current clinical interventions are able to prevent further ischemia but unable to replace the lost cardiomyocytes. People who have suffered from a heart attack are therefore currently unable to regain 100% cardiac function.
However, new studies have shown that human engineered cardiac tissue offers a potential source of cardiomyocyte regeneration. Tissue engineering is the process of combing cells, such as human pluripotent stem cells (hPSCs), and biochemical factors to improve or replace tissue. hPSCs are often used because they have the potential to differentiate into almost any type of cell in the body, and therefore have the unique ability to generate unlimited numbers of hPSC-derived cardiomyocytes (hPSC-CMs).
A recent study at the University of Pennsylvania’s Center for Advanced Medicine created patches of human engineered heart tissue grown from hPSC-CMs. The three-dimensional patches were implanted over large defects in guinea pig hearts seven days after the animals experienced cardiac injury. Twenty-eight days later, the injured areas were partly remuscularized and the heart pumped 31% more effectively. The areas also showed cardiomyocyte proliferation. This successful integration of hPSC-CMs into animal hearts suggests great potential for the use of the cells in clinical practice.
Although hPSC-CMs have some challenges to overcome before being introduced into clinical practice, success in several similar studies proves that cardiac regenerative therapy is not far in the future, providing a sense of optimism for the advancement of heart disease treatment.
Caroline Marone ’17