Into the Heart: What Contributions to Cardiac Regeneration?

One of the leading causes of death in the western world is undoubtedly cardiovascular diseases, with special reference to myocardial infarction and consequent heart failure. The therapeutic strategies adopted nowadays are based on drug therapy, coronary artery angioplasty, pacemakers and implantable defibrillator, coronary artery bypass grafts, ventricular remodeling, dynamic cardiomyoplasty, organ transplantation, and mechanical circulatory assistance devices. However, all these procedures are often ineffective and invasive. Moreover, myocardial heart engineering has experienced significant progress over the last 10 years, with fundamental advances in stem cell biology and knowledge of biomaterials. However, one of the limiting factors in the overall interpretation of clinical results obtained by cell therapy is represented by the lack of in vivo visualization of the injected cells and of their fate within the myocardium. This chapter shows that X-ray microtomography (microCT) and in particular phase-contrast imaging may offer the unique possibility to detect with high definition and resolution the three-dimensional spatial distribution of stem cells, once injected inside an infarcted heart in small animal models. It was shown, through microCT, the migration of these cells within the damaged cardiac tissue, achieving an appropriate identification and localization of the injected cells. Thus, phase-contrast microCT appears to be an innovative and exclusive way to investigate the cellular events involved in cardiac regeneration and represents a promising tool for future clinical translations.