Cardiovascular disease (CVD) leading to "heart attack" (acute myocardial infarction; MI) is the major cause of morbidity and mortality in humans and is a growing global health problem. In the UK alone someone has a heart attack every 7 minutes and the cost to the UK economy is in the region of £15 billion due to the impact on primary care and lost productivity.
Heart transplantation is the only current long term solution but is complicated by host immune rejection and compounded by the fact that demand continually outstrips the availability of donor hearts.
In this regard, a number of clinical trials have attempted to regenerate heart muscle after MI through the use of a variety of autologous cells, including bone marrow stem cells, but there is no consensus that these cells can differentiate to contribute new muscle efficiently and, perhaps for this reason, the clinical improvement has generally been disappointing. Hence, there continues to be an urgent need to identify the most promising cardiovascular stem cells for achieving therapeutic regeneration. Underpinning this is the need to determine how stem or progenitor cells can be programmed towards a cardiovascular fate, prior to establishing interventional strategies to induce efficient cardiac muscle formation, either via cell transplantation or through the stimulation of resident cardiac progenitors.