Progress In Gene Therapy For Chronic Heart Failure

Chronic heart failure(CHF)is still the leading cause of morbidity and mortality worldwide.It has already brought much more burden both in economic and social aspects to mankind.Although conventional therapy has a steady and substantial progress in reducing mortality from heart failure,novel pharmacologic and surgical intervention was not effective in extending the 5 years survival rate.Therefore,it is necessary to explore new therapies.Gene therapy was introduced in 1970 s with the development of recombinant DNA Technology.Due to recent progress in myocardial metabolism and application of vector based gene transfer strategies in animal models and initial clinical trials,fortunately,gene therapy would probably afford an ideal treatment alternative for CHF.In last 2 decades,many research have been done about gene therapy for heart failure with different genes,different signal transduction passages and different delivery methods.It has given us a bright prospect to treat advanced heart failure.Current researches in ischemic heart disease(IHD)mainly focus on stimulating angiogenesis,modifying the coronary vascular environment and improving the vascular endothelial function with localized gene coated catheters and stents.Compared with standard ischemic heart disease treatment,the main goal of gene therapy for HF is to inhibit apoptosis,and reduce the undesirable remodeling and increase the contractility through the most efficient cardiomyocyte transfection.In this paper,we would review variable gene transfer technologies in ischemic heart disease and heart failure models,discuss the advantages and disadvantages of these strategies in vector-mediated cardiac gene delivery,and mainly focus on molecular cardiac surgery delivery system,a dramatic and high efficiency approach.