Stem Cells and Therapies in Cardiac Regeneration

Ischemic heart diseases (IHD) are a significant cause of death all over the world increasing the cardiovascular disease (CVD) burden. Blockade of coronary arteries followed by an infarct in the heart is the basis of the heart failure (HF), the most significant health issue worldwide. Inadequate cardiac regeneration and decreased number of functional cardiomyocytes are the major underlying cause that leads to the fatality. Therefore, new therapies and methods to remuscularize and regenerate the damaged cardiac myocytes toward proliferation are an immediate requirement. This leads to novel strategies like utilizing stem cells (SCs) or increasing the number of cell cycles of the cardiac myocytes for regeneration of the heart muscle. SCs and embryonic stem cells (ESCs) played a very significant role in differentiating into cardiomyocytes both in vitro and in vivo. The heart also hosts multipotent progenitor cells which along with the ESCs can assist in the development of the specific cell types that would eventually treat various heart diseases. The potential chances of rejection of the ESCs by the immune system drifted in the direction of induced pluripotent stem cells (iPSC) that are tolerated by the host immune response. Apart from the utility of the SCs in the proliferation of the cardiac myocytes, the role of noncoding RNAs also played a significant role. Several studies have reported that either inhibition or upregulation of certain miRNAs improves the left-ventricular (LV) function after myocardial infarction (MI). Although miRNAs have proved to be a promising potential therapy for the cardiac regeneration by the proliferation of the cardiac myocytes, still these investigations in human are scarce. This chapter aims at reviewing the various means for cardiac regeneration and also highlight the existing gaps.