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(Circulation. 2003;107:2638.)
© 2003 American Heart Association, Inc.

Editorials

The Way to a Human’s Heart Is Through the Stomach

Visceral Endoderm-Like Cells Drive Human Embryonic Stem Cells to a Cardiac Fate

Teruya Nakamura, MD, PhD; Michael D. Schneider, MD

From the Center for Cardiovascular Development, Departments of Medicine, Molecular and Cellular Biology, and Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Tex.

Correspondence to Dr Michael D. Schneider, Center for Cardiovascular Development, Baylor College of Medicine, One Baylor Plaza, Rm 506D, Houston, TX 77030. E-mail michaels@bcm.tmc.edu

Key Words: Editorials • stem cells • cells, visceral • myocytes

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

Heart failure due to myocardial infarction is the leading cause of morbidity and mortality in developed countries.¹ While that point needs no reiteration for the Circulation audience, its corollary does: that heart failure, in essence, is a myocyte-deficiency disease. Cell death, whether from acute infarction alone or from sustained sporadic losses in chronic heart failure, is not matched by sufficient cell replacement. Adult cardiac muscle cells have long lost much if not all of their capacity for proliferative growth, and differences in interpretation hinge on shadings between "none" and "almost none."^2,3 What cell replacement does occur occurs by other means, including the recruitment of undifferentiated progenitor cells—eg, from their niche in bone marrow through the circulation to the injured myocardium.⁴

See p 2733

Advances in fundamental molecular and cellular biology have paved the way for development of tissue engineering and regenerative medicine as a new therapeutic paradigm, in effect, the Regeneration Superhighway. Among such advances, so-called stem cells have been greeted with greatest enthusiasm, as well as religious and political alarm. Replacing dead cardiac muscle cells with living ones to preserve pump function is a goal of indisputable merit. But which cells have this capacity to transform from something that isn’t a cardiac myocyte into something that is? Among the potential sources, why has controversy arisen for some? Which can be propagated and expanded best in tissue culture? How faithful is their differentiation, compared with "real" cardiac muscle cells? And, what governs their conversion?

The concept of "stemness" embraces two . . . [Full Text of this Article]

Related Article:

Differentiation of Human Embryonic Stem Cells to Cardiomyocytes: Role of Coculture With Visceral Endoderm-Like Cells

Christine Mummery, Dorien Ward-van Oostwaard, Pieter Doevendans, Rene Spijker, Stieneke van den Brink, Rutger Hassink, Marcel van der Heyden, Tobias Opthof, Martin Pera, Aart Brutel de la Riviere, Robert Passier, and Leon Tertoolen
Circulation 2003 107: 2733-2740. [Abstract] [Full Text]

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				A. Leri, J. Kajstura, and P. Anversa Cardiac Stem Cells and Mechanisms of Myocardial Regeneration Physiol Rev, October 1, 2005; 85(4): 1373 - 1416. [Abstract] [Full Text] [PDF]

				P. Anversa, J. Kajstura, and A. Leri Circulating Progenitor Cells: Search for an Identity Circulation, November 16, 2004; 110(20): 3158 - 3160. [Full Text] [PDF]