Contemporary perspective on endogenous myocardial regeneration

Core Tip

Core tip: Unlike in primitive vertebrates, any regenerative effort in adult mammalian hearts after an acute event remains unsatisfactory. Most efforts to repopulate failing hearts with functioning and integrated cardiomyocytes have not achieved clinical importance. In this overview, after describing several options for endogenous myocardial repair, we support the notion of a paradigm change towards inducible developmental processes in regeneration research. Major efforts have been made to convert tissues upstream in the Waddington scheme. Recently, stress transformed acquired pluripotency raised enormous expectations, but results and proof of concept were seriously questioned. We want to introduce pressure-controlled intermittent coronary sinus occlusion as a potential resource to decipher the unsolved equation of re-inducing the developmental processes in the human heart.