Cardiac failure therapeutic strategies

No single test is available to confirm the diagnosis of heartfailure. Because the syndrome of heart failure can be caused or worsened by multiple cardiac and noncardiac disorders, accurate diagnosis is essential for development of therapeutic strategies. Heart failure often is suspected initially in a patient based on the symptoms. These frequently will include dyspnea, exercise intolerance, fatigue, and/or fluid retention. However, it must be emphasized that signs and symptoms lack sensitivity for diagnosing heart failure because these symptoms are found frequently with other disorders such as pulmonary disease. Even in patients with known heart failure, there is poor correlation between the presence or severity of symptoms and hemodynamic abnormality. 

A possible novel therapeutic strategy for heart failure following myocardial infarction may be to increase the number of functional myocytes within the diseased area by the implantation of exogenous myogenic cells. Early studies used neonatal rat cardiomyocytes for transplantation, as these cells have cardiac phenotype and still retain some proliferation capacity [2-4]. Fetal cardiomyocyte cell grafts showed the formation of cell-to-cell contacts, complete with gap junction proteins [4]. Moreover, cultured human fetal cardiomyocytes were shown to survive, and fetal rat cardiomyocytes were shown to be present in the infarcted rats hearts for up to 6 months after transplantation [5]. Further studies in animal models of myocardial infarction showed that grafting of cardiomyocytes from fetal and neonatal sources was asso-... 

McMullen, J.R. and G.L. Jennings. 2007. Differences between pathological and physiological cardiac hypertrophy Novel therapeutic strategies to treat heart failure. Clinical and Experimental Pharmacology and Physiology 34(4) 255-62. 

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