Revitalizing the heart: strategies and tools for cardiomyocyte regeneration post-myocardial infarction

Abstract

Myocardial infarction (MI) causes the loss of millions of cardiomyocytes, and current treatments do not address this root issue. New therapies focus on stimulating cardiomyocyte division in the adult heart, inspired by the regenerative capacities of lower vertebrates and neonatal mice. This review explores strategies for heart regeneration, offers insights into cardiomyocyte proliferation, evaluates in vivo models, and discusses integrating in vitro human cardiac models to advance cardiac regeneration research.

Fig. 1. Mechanisms of cardiac regeneration loss in postnatal mammals.

The transition from fetal to adult stages encompasses several changes, including modulation of oxygen levels, shifts in energy metabolism, regulation by epigenetic factors and hormones, modifications in cytoarchitecture and extracellular matrix components and rigidity, adjustments in cardiac cell populations, control of the cell-cycle, activation or deactivation of signalling pathways, and the roles played by transcription factors. The understanding of this fetal-to-adult cardiac transition has highlighted numerous potential molecular strategies for cardiac regeneration. Created in BioRender. Axelle, B. (2021) BioRender.com/n07c558.

Fig. 2. Experimental models and their limitations.

Advantages and disadvantages of animal and in vitro models for cardiac regenerative studies. Created in BioRender. Axelle, B. (2021) BioRender.com/u90h698.