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(Circulation. 2006;114:2575-2577.)
© 2006 American Heart Association, Inc.

Editorial

Cardiac Regeneration

Materials Can Improve the Passive Properties of Myocardium, but Cell Therapy Must Do More

Glenn R. Gaudette, PhD; Ira S. Cohen, MD, PhD

From the Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, Mass (G.R.G.), and Department of Physiology and Biophysics and Institute for Molecular Cardiology, Stony Brook University, Stony Brook, NY (I.S.C.).

Correspondence to Glenn R. Gaudette, PhD, Assistant Professor, Department of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609. E-mail gaudette@wpi.edu

Key Words: Editorials • myocardium • cells • mechanics

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Cellular therapy to replace lost myocardial mass with new, contractile myocardium has the potential to revolutionize the treatment of myocardial infarction and heart failure. Studies have shown small but consistent improvements in mechanical function, largely independent of the cell type chosen. The reasons for this lack of specificity are presently unknown. In the current issue of Circulation, Wall et al¹ present computational models that suggest that the injection of passive materials alone may improve ejection fraction and reduce wall stress in the ventricle. The present study raises the possibility that some cellular therapies contribute to increased heart function purely through a passive mechanism rather than through active contraction associated with the addition of new myocytes. Because materials lack many of the uncertainties associated with cellular therapies (eg, mode of delivery, homing, immune rejection, arrhythmias), and because they can be engineered to have a number of inherent advantages (eg, uniformity, reliability, greater safety, reduced cost), one conclusion of the current finding is that biomaterials alone may be important for future cardiac therapy.

Article p 2627

Given the results of this study by Wall and colleagues,¹ it is also clear that passive contribution must be separated from active contribution to evaluate the efficacy of any cell therapy approach. Passive contribution can result from replacing a stiff material, such as an infarct, with a more compliant material. Completely replacing the infarcted tissue with a compliant scaffold can accomplish this task. Matsubayashi and colleagues² demonstrated that passive properties can improve global heart function . . . [Full Text of this Article]

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