The future of regenerative therapy in patients with chronic heart failure

Regenerative therapy is a rapidly growing branch of science and medicine, which could have an important impact on the treatment of heart failure, a major cause of disability and death. Regeneration of the damaged myocardium in heart failure can be achieved through different strategies aimed at 'reviving' existing malfunctioning cells, repopulating the myocardium by new cells from exogenous or endogenous sources, altering the extracellular matrix, or increasing blood supply by enhancing vasculogenesis. To date, the clinical application of some of these strategies has had minimal or no impact on the global epidemic of chronic heart failure. However, several small clinical trials have reported varying degrees of functional improvement which could be considerable in some cases. We here review recent progress in the field, suggest an integrated approach, and outline the many gaps in our knowledge which need to be resolved by intensive laboratory research if regenerative therapy for chronic heart failure is to achieve its future potential.