Inducing Embryonic Stem Cells to Become Cardiomyocytes

I.S. Cohen and G.R. Gaudette (eds.), Regenerating the Heart, Stem Cell Biology and Regenerative Medicine, DOI 10.1007/978-1-61779-021-8_2, © Springer Science+Business Media, LLC 2011 Abstract Many forms of heart disease are associated with a decrease in the number of functional cardiomyocytes. These include congenital defects (e.g. hypoplastic and noncompaction syndromes) as well as acquired injuries (e.g. expo sure to cardiotoxic agents or injuries resulting from coronary artery disease, hypertension, or surgical interventions). Although the adult mammalian heart retains some capacity for cardiomyocyte renewal (resulting from cardiomyocyte proliferation and/or cardiomyogenic stem cell activity), the magnitude of this regenerative process is insufficient to effect repair of substantively damaged hearts. It has become clear that exogenous cardiomyocytes transplanted into adult hearts are able to structurally and functionally integrate. It has also become clear that embryonic stem cells (ESCs), as well as induced progenitors with ESC-like characteristics, are able to generate bona fide cardiomyocytes in vitro and in vivo. These cells thus constitute a potential source of donor cardiomyocytes for therapeutic interventions in damaged hearts. This chapter reviews spontaneous cardiomyogenic differentiation in ESCs, methods used to generate enriched populations of ESC-derived cardiomyocytes, and current results obtained after engraftment of ESC-derived cardiomyocytes or cardiomyogenic precursors.