Mechanical control of adult mesenchymal stem cells in cardiac applications

Introduction: Mesenchymal Stem Cells and the Cardiac Microenvironment Adult mesenchymal stem cells (MSCs) are multipotent progenitor cells that have shown promise in a wide range of regenerative treatments spanning fields as diverse as oncology, orthopedics, and cardiology. In recent years, MSCs have been implanted into patients with various myocardium-related pathologies, including dilated cardiomyopathy, concentric hypertrophy, and others related to heart failure. Although the mechanism by which these cells repair damaged tissue or restore function is currently a topic of debate, these cells have been shown to have beneficial effects in regenerating myocardial function upon injection [1,2,3–11]. It has been hypothesized that the implanted cells regenerate tissue through paracrine effects [12–14], cell fusion with damaged cells [15–18], as well as through differentiation into cardiomyocytes [19–22]. However, the extent to which damaged myocardium uses stem cell homing from the circulation as a repair mechanism is not clear, bringing into question the effectiveness of cell implantation [1]. Regardless of whether MSCs act by one of these mechanisms or a combination of them, controlling their phenotype is highly relevant to the repair of damaged myocardial tissue. This chapter focuses on the use of these cells for the regeneration of damaged myocardial tissue, particularly the effects of mechanical stimuli in controlling the phenotype and function of MSCs in cardiac applications.