Regenerative cardiac pharmacology: Translating stem cell biology into therapeutic solutions

Heart Disease: An Epidemic Ischemic heart disease accounts for 20 million of global deaths annually. Advanced ischemic cardiomyopathy manifests as an overt congestive heart failure syndrome, the largest cause of repeat hospitalizations and mortality in the developed world. At present, more than 5 million Americans and 20 million patients worldwide have heart failure with 550,000 new cases recorded each year in the United States alone. Symptomatic heart failure has a poor prognosis and carries a 5-year mortality rate exceeding 50 percent. Despite aggressive medical management and increased access to interventional therapies, the malignant nature of heart failure imposes an annual cost of more than $80 billion in the United States, warranting new therapeutic solutions. Revascularization at the time of infarction has reduced acute mortality but has paradoxically caused an epidemic of chronic heart failure because of massive myocardial damage in the surviving patient population. Current clinical management is focused at symptomatic palliation yet lacks the capacity to salvage the infarcted myocardium. Life-extending measures – such as left ventricular assist devices or organ replacement – are ultimately the only therapeutic options. However, only a limited number of patients can benefit from such complex interventions. Accordingly, there is a large and immediate need for the development and implementation of effective repair strategies accessible to a broad patient population.