| Heart failure following a myocardial infarction is currently the leading cause of death in the United States. Heart transplantation remains the only successful treatment for those patients suffering from end-stage heart failure despite the paucity of donor organs. Various alternative treatments have been examined, including angiogenic growth factor delivery, cell therapy, and left ventricular restraints. The emerging field of myocardial tissue engineering is also providing exciting possibilities. To date, tissue engineering approaches to the myocardium have involved cell injections or the implantation of in vitro engineered cardiac tissue. In this work, we present a novel approach to cardiac repair and reconstruction, which we have termed in situ engineered myocardial tissue. Tissue engineering involves the combination of growth factors, cell therapy, and biomaterial scaffolds to repair lost or damaged tissue. The aim of this work was to determine which combination of these three components was best suited for cardiac repair via in situ myocardial tissue engineering. The results of the following studies indicate that Pleiotrophin is an effective angiogenic agent in ischemic myocardium; however, it is the combination of skeletal myoblasts and a fibrin glue scaffold that is the most effective treatment for cardiac repair. Our results also indicate that delivery of the fibrin scaffold alone may also be a potential treatment for those patients suffering from myocardial infarctions. |
