Acute myocardial infarction (MI), typically caused by coronary artery occlusion and ischemia, is a leading cause of death worldwide. For those fortunate enough to survive MI, necrotic heart muscle is replaced in the next few weeks by collagen-rich scar tissue. While the scar provides a rapid solution, it is not contractile and over the long term weakens the heart and increases risk for serious problems. The development of regenerative therapies that promote the survival or regeneration of destroyed heart muscle would be of enormous social and economic impact.
It has become clear that the heart does not possess a stem cell compartment of sufficient regenerative capacity to create significant amounts of new heart muscle. In nature, animals like zebrafish regenerate heart muscle effectively by direct division of cardiac muscle cells. At Duke, research laboratories are exploring how examples of heart regeneration like this occurs, and they are developing methods to reconstitute lost muscle, with the ultimate goal of endowing greater regenerative capacity to the human heart.