New trends in treatment of heart failure: Cellular cardiomyoplasty, gene therapy and nuclear transfer

Heart failure is becoming a major public health problem, and is expected to be the prevailing cardiac disease of the next century. In the majority of patients, heart failure develops as a consequence of coronary atherosclerosis and myocardial infarction. Current therapeutic options for heart failure include medical therapy, of proven but limited benefit, and surgical options, which have either restricted applicability or unproven benefit. Necrosis of cardiomyocytes, and their subsequent replacement by fibrous scar, is an essentially irreversible process. Adult human cardiomyocytes have only a very limited ability to proliferate, and the myocardium has no myogenic stem cells capable of replacing the lost cardiomyocytes. Cell transplantation, gene therapy and nuclear transfer to repair injured myocardium are new approaches in the treatment of cardiovascular disease.