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Cardiovascular Engineering - New Organ Alliance

Cardiovasular Engineering

Despite advances, cardiovascular disease remains the leading cause of death worldwide, bioengineering solutions to cardiovascular disease can help.

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Cardiovascular 
engineering

Controlling risk factors leading to cardiovascular disease remains an issue for many Americans.  Exercise, obesity, cholesterol levels and diabetes remain as significant issues that contribute to the development of heart disease. Because of this, cardiovascular disease remains the number 1 killer throughout the nation.

The innate capacity of the human heart for self-regeneration is not enough to compensate the loss of cardiac muscle after an ischemic injury (heart attack).  Interventions and therapies have been developed and are helpful in buying time, but ultimately cannot preserve the life of the patient.  Millions of patients each year could be helped by the ability to regenerate cardiomyocytes.  Ultimately, heart failure usually results from a deficiency of cardiomyocytes. Heart regeneration occurs naturally in lower vertebrates and in developing mammals. However, human heart regeneration becomes quickly limited following birth, and this is the case with most mammals.


Of all the organs in the body, the heart is the one with the least regenerative capacity; however, current research has begun to close the gap by advancing our understanding of how to bioengineer new cardiac cells, tissues, and even who organs. For example:


  • Significant advances have been made in understanding how regeneration is activated in animal models (such as zebrafish) where regeneration occurs naturally.
  • Recent work has also resulted in stem cells differentiating to beating cardiomyocytes in space.
  • Re-working human hearts (perfusion-decellularization of human cadaveric hearts) is showing promise.


Many other significant advances could also be listed, this is a dynamic and active field.  But foundational milestones and challenges have not previously been clearly described in a succinct manner.  The work of the New Organ Cardiovascular Engineering Committee will help identify and clarify significant specific challenges and sub-challenges associated with the heart. 

References

  • Rebouças J de S, Santos-Magalhães NS, Formiga FR. Cardiac Regeneration using Growth Factors: Advances and Challenges. Arquivos Brasileiros de Cardiologia. 2016;107(3):271-275. doi:10.5935/abc.20160097.
  • Rosamond W, Flegal K, Furuie K, Greenlund K, Haase V, Ho M, et al. Heart disease and stroke statistics-2008 update a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008;117(4):e25–e146.
  • Segers VF, Lee RT. Stem-cell therapy for cardiac disease. Nature. 2008;451(7181):937–942.
  • Laflamme MA, Murry CE. Heart Regeneration. Nature. 2011;473(7347):326-335. doi:10.1038/nature10147.
  • Kang J, Hu J, Karra R, Dickson A, Tornini V, Nachtrab G, Gemberling M, Goldman J, Black B, Poss K.  Nature 532, 201-206, 14 April 2016.  doi:10.1038/nature17644
  • Wu, Joseph Effects of Microgravity on Stem Cell-Derived Heart Cells, NASA Research Publication.
  • Guyette JP, Charest JM, Mills RW, Jank BJ, Moser PT, Gilpil, SE, Gershlak, JR, Okamoto, T, Gonzalez G, Milan DJ, Gaudette GR, Ott HC. Circulation Research. 2016;118:56-72  https://doi.org/10.1161/CIRCRESAHA.115.306874

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