Cardiac Cell Therapy for Heart Repair: Should the Cells Be Left Out?
Cardiovascular disease (CVD) is still the leading cause of death worldwide. Coronary arteryocclusion, or myocardial infarction (MI) causes massive loss of cardiomyocytes. The ischemia areais eventually replaced by a fibrotic scar. From the mechanical dysfunctions of the scar in electronictransduction, contraction and compliance, pathological cardiac dilation and heart failure develops.Once end-stage heart failure occurs, the only option is to perform heart transplantation. The sequentialchanges are termed cardiac remodeling, and are due to the lack of endogenous regenerativeactions in the adult human heart. Regenerative medicine and biomedical engineering strategies havebeen pursued to repair the damaged heart and to restore normal cardiac function. Such strategiesinclude both cellular and acellular products, in combination with biomaterials. In addition, substantialprogress has been made to elucidate the molecular and cellular mechanisms underlying heartrepair and regeneration. In this review, we summarize and discuss current therapeutic approachesfor cardiac repair and provide a perspective on novel strategies that holding potential opportunitiesfor future research and clinical translation.