Heart failure is a significant cause of morbidity and mortality globally. An estimated 38 million patients suffer from heart failure worldwide, and its
prevalence is expected to increase. In Canada, 1% of the population suffers from heart failure and the number of admissions for this disease is expected
to increase 300% from 1996 to 2050. In the United States, the number of patients with heart failure is estimated to increase 25% by 2030 with an
estimated cost of $69.8 billion. Despite advances in modern medical care, heart transplantation remains the definitive treatment. Heart transplantation
has had progressive, improved success in survival due to improvements in immuno-suppression. However, the availability of donor organs remains
limited. Mechanical circulatory support has been an increasingly utilized option for patients with end-stage heart failure as bridge-to-transplantation, or
for permanent destination therapy, but multiple complications can occur. As an alternative, stem cell therapy has emerged as a promising new field for the
treatment for heart failure. It brings the possibility of regenerating new functional myocardium from donated or autologous cells. However, this field is still
in its early stages and clinical success has been modest, to date. This field may gain assistance by developments in nanotechnology and tissue engineering where patches, grafts, and even whole replacement organs may shape the future of heart failure therapy. We review the current and future states of these advancing technologies.
Author(s): John M. Connell, MD, and Dominique Shum-Tim, MD, MSc, FRCSC