Biomedical Engineering Reference
In-Depth Information
Chapter 16
Nanotechnology and Cardiovascular
Tissue Engineering
Savneet Kaur and Upasana Rishiraj
School of Biotechnology, Gautam Buddha University, Uttar Pradesh, India
Introduction
Cardiovascular diseases are one of the leading causes of death and disability worldwide.
These diseases lead to loss of cardiac tissue through death of the cells by apoptosis and
necrosis. The average left ventricle contains approximately 4 billion cardiomyocytes and the
myocyte deficit in infarction-induced heart failure is about one billion cardiomyocytes [1].
The remaining myocytes are unable to reconstitute the host tissue, and the diseased heart
deteriorates functionally with time. Current therapeutic approaches available, including
medical therapy, mechanical left-ventricular-assist devices, and cardiac transplantation, are
primarily focused at limiting disease progression rather than repair and restoration of
healthy tissue and function. The limited efficacy and co-morbidity of these treatments and
shortage of donor hearts have thus increased the interest to investigate other alternative and
additional long-term therapeutic strategies. In this context, cell-based therapies and cardio-
vascular tissue-engineering techniques for myocardial regeneration have gained significant
impetus to achieve cardiovascular repair.
Cell Therapies in Cardiovascular Diseases
The concept of cell therapy and transplantation as a means to increase myocyte number in
injured hearts first appeared in the early 1990s. Since then, several cell types that might
replace necrotic tissue and minimize scarring have been considered (Table 16.1). Initial
cardiac cell-transplantation efforts have utilized skeletal myoblasts, adult stem cells isolated
from skeletal muscle biopsies [2]. In the bone marrow, three populations of stem cells: hema-
topoietic stem cells (HSCs), mesenchymal stem cells (MSCs), and endothelial progenitor
cells (EPCs) have been reported to contribute to heart muscle repair. In animal models of
heart disease and several patient trials, administration of bone-marrow-derived stem cells
has been shown to cause an increase in tissue perfusion, a reduction in apoptosis, reduction
in infarct size, and improvements in cardiac function [3-5]. An alternative approach used
