Cardiac Regeneration and Repair: From Mechanisms to Therapeutic Strategies

Cardiovascular diseases lead the ranking of lethal causalities worldwide, which has been largely attributed to the limited regenerative capacity of the human heart. This restricted myocardial renewing capacity and exacerbated fibrosis often result in heart failure. Currently, the only long-term efficient therapy for this condition is whole-organ transplantation, which is limited by the shortage of donors and physiological constraints. Hence, several cutting-edge strategies to improve cardiac function, namely, gene and cellular therapies, biomaterial design and delivery, either solely or combined, are under investigation. In parallel, studies on heart development and on regenerative mechanisms evolutionarily conserved amongst species have highlighted molecules that hold potential for future therapeutic purposes. This perspective gained further relevance with recent advances showing that murine hearts display regenerative potential yet restrict to a limited period after birth. This chapter will revisit the regenerative capacity of the heart across species and throughout the lifespan, while discussing current advances in therapeutic alternatives for heart failure.