Regenerative Therapy for Patients with Congenital Heart Disease

Abstract

Congenital heart disease (CHD) is the most common birth defect, affecting 1 in 100 babies. Among CHDs, single ventricle (SV) physiologies, such as hypoplastic left heart syndrome and tricuspid atresia, are particularly severe conditions that require multiple palliative surgeries, including the Fontan procedure. Although the management strategies for SV patients have markedly improved, the prevalence of ventricular dysfunction continues to increase over time, especially after the Fontan procedure. At present, the final treatment for SV patients who develop heart failure is heart transplantation; however, transplantation is difficult to achieve because of severe donor shortages. Recently, various regenerative therapies for heart failure have been developed that increase cardiomyocytes and restore cardiac function, with promising results in adults. The clinical application of various forms of regenerative medicine for CHD patients with heart failure is highly anticipated, and the latest research in this field is reviewed here. In addition, regenerative therapy is important for children with CHD because of their natural growth. The ideal pediatric cardiovascular device would have the potential to adapt to a child's growth. Therefore, if a device that increases in size in accordance with the patient's growth could be developed using regenerative medicine, it would be highly beneficial. This review provides an overview of the available regenerative technologies for CHD patients.

NOD-like receptor protein 3 and high mobility group box-1 are associated with prognosis of patients with congenital heart disease

“…Congenital heart disease is the most common birth defect, which is characterized by structural and functional abnormalities of the blood vessels caused by genetic and environmental factors. 17,18 Children with CHD have aberrant haemodynamics, including cyanosis, PHA and abnormalities of the vertebral artery, which in turn lead to serious complications such as arrhythmias, cardiac dysfunction or heart failure. 19,20 Several blood biomarkers have been proposed for the diagnosis and prognosis of cardiovascular disease (CVD).…”

New Aspects in the Diagnosis and Therapy of Fetal Hypoplastic Left Heart Syndrome

“…It is believed that stem cells are present in the perivascular regions of various tissue types including the myocardium. Because of their intrinsic properties, they are able to secrete different angiogenic factors 78 which can increase myocardial angiogenesis, replace injured myocardium and improve myocardial function 79 . Clinical trials for stem cell therapy in CHD are mostly carried out in patients with single ventricle circulation, as can occur with HLHS.…”

The effect of stem cells in congenital heart disease

“…Stem cell therapy could become a potential option to this which is why research has become recently highly anticipated. This stems further research for stem cell therapy and the idea of an alternative option to avoid heart transplantation [21]. The three consecutive surgeries: Norwood, Glenn and Fontan, are performed within the first few weeks of birth, the second between 4 to 6 months and the third within the first 4 years.…”

“…Particularly, research has demonstrated the injection of cardiomyocyte-like cells generated from iPSCs on MI animal models and shown that the iPSCs are able to integrate with the cardiac tissue and thus improve cardiac function [21]. One report demonstrated the generation of iPS cell-derived cardiomyocyte sheets and proved that these cells exhibit contraction and relaxation in vivo with the myocardium [61].…”