Myocardial tissue engineering and heart muscle repair

Cardiovascular diseases, including myocardial infarction and heart failure, are the main causes of death worldwide. Classical pharmacological treatment may halt, but cannot reverse the underlying disease process. Cellular cardiomyoplasty has the potential to reconstruct myocardium in situ; yet, it is hampered by poor cell survival, engraftment, and differentiation. Tissue engineering has emerged as an alternative cell-based approach, aiming at partial or full replacement of damaged organs with in vitro generated tissue equivalents. However, limited availability of therapeutic cardiomyocytes poses a major challenge on cell-based and in particular tissue engineering-based therapies. Rapidly evolving stem cell technologies, enabling mass cultures may overcome this limitation. Translating available experimental concepts into clinical reality will be the ultimate challenge. This review discusses potentially therapeutic cells for cardiac repair, current stem cell-based myocardial tissue engineering strategies, and the requirements for a translation of myocardial tissue engineering into clinical practice.