A Clinical Commentary on the Article “Injectable Acellular Hydrogels for Cardiac Repair”

Left ventricular (LV) remodeling caused by a myocardial infarction (MI) is responsible for almost 70 % of the five million cases of heart failure in the USA [1]. Over the past 50 years, the establishment of intensive care units, antiarrhythmic drugs, and reperfusion therapy has improved early survival after acute MI. This success has paradoxically contributed to the increased incidence in heart failure. While the use of optimal pharmacologic therapy can slow the progression to heart failure after MI, the incidence of the disease continues to grow, and survival rates, once clinical symptoms appear, have not increased appreciably since the 1970s [2]. The outlook for patients with end-stage heart failure remains particularly poor. Dissatisfaction with the treatment options for end-stage heart failure has resulted in an increased interest in developing interventions that can be implemented early after MI with the intent of slowing or arresting the progression to heart failure. Cellular therapy with any number of cell lines has been championed by many investigators as a possible means of regenerating myocardium and ameliorating adverse LV remodeling after MI. In spite of extensive enthusiasm for this therapeutic approach, regeneration of electromechanically integrated myocardium in the infarct zone has never been demonstrated to occur in patient