Cardiac regeneration time to revisit nature

It is hard to imagine any topic in cardiovascular science that has been more hotly contested for the past 2 decades than cardiovascular regenerative medicine. The flavor of the day with regard to stem cell types fluctuates, yet frst-in-human studies of a regenerative approach with defnitive results remain elusive. The good news is that many of us continue to toil away in our laboratories and clinical trials in pursuit of this Promethean quest and that most stem cell types used have proven to be safe, if not always effective. We think that past paradigms have not always been organically founded on the basis of prevailing mechanisms found in nature and in our own evolutionary history. Thus, a more rigorous focus on developmental biology and genetics is of paramount importance to identify the best targets. This must be coupled with preclinical testing in large animal models to assess the success of any given gene or cell therapy before clinical trials.