Brisa Peñ a, Valentina Martinelli, Mark Jeong, Susanna Bosi, Romano Lapasin, Matthew R. G. Taylor, Carlin S. Long, Robin Shandas, Daewon Park, and Luisa Mestron

(ACS) – INTRODUCTION: Heart failure continues to be a leading cause of death, characterized by high mortality and morbidity, affecting over 5 million persons in the United States. Cardiomyopathies are a clinically and genetically heterogeneous group of heart muscle disorders characterized by life-threatening arrhythmias, sudden death, and progression toward heart failure.1,2 Most cardiomyopathies at the late stage of heart failure exhibit CM loss.3 In addition, the adult mammalian heart does not sufficiently regenerate CMs after injury.4 Therefore, at the end-stage of heart failure, heart transplantation remains the best option.5 However, replacing the failed heart with a healthy one raises several limitations such as shortage of organs available for transplantation, immune rejection, surgical complications, and so on.6,7 Due to these restrictions, innovative alternatives are urgently needed to repair the wounded heart and to permanently restore its function.8 Direct injection of single cells or small clusters of cells into the cardiac muscle has been used as a therapeutic approach to heal damaged heart tissue.9 However, cell therapy faces several limitations, such as low rate of cell survival and poor retention of transplanted cells in the injured tissue; in addition, the cell source, the route of administration, and cell post-transplantation arrhythmias are other major limitations that affect treatment success.

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