Stem cell research is one that is widely debated amongst various religions, cultures, and political groups. The question as to when life actually begins is the epicenter of this worldwide quarrel, and may not be settled for some time. Although this may be true, one fact that cannot be denied is that stem cell research has led to many life saving discoveries in various sectors of scientific research. In regards to the ethical dilemma of stem cells, recent developments in induced pluripotent stem cells (iPSCs) have made it possible to explore the applications of stem cells while avoiding the ethical problems associated with embryonic stem cell research (Seki & Fekuda, 2015). One intriguing area in stem cell research is the potential applications for them in the treatment of cardiac diseases. Studies have explored the potential uses for stem cells for the treatment of heart disease (Yamakawa & Ieda, 2015). Additionally, stem cells have been explored for the treatment of heart failure and myocardial infarction (Rasmussen, et al., 2013). Stem cells and how they may be used for the treatment of various cardiac diseases is an exciting topic and has the potential to change future approaches to the treatment. This paper will examine the applications and significance of stem cells in relation to these common cardiac pathologies. Heart disease is one of the leading causes of death in developed countries and currently there are few effective treatment options available (Yamakawa & Ieda, 2015). This it is important to research and make state of the art treatments available to address this issue. The use of stem cells may become an option for treatment of coronary artery disease (CAD). One approach has involved the use of endothelial progenitor cells (EPCs). In one study, EPCs were introduced into areas affected by ischemia and have been able to generate proliferation of new vasculature (Webster, 2005). Furthermore, iPSCs have also been explored for their potential uses for increased angiogenesis. One study has been able to develop methods both in vitro and in vivo that produced angiogenesis and the formation of new vascular networks. (Kawamoto et al., 2013). The angiogenic effects of iPSCs have the potential to address the physiological consequences of CAD by helping to produce new and healthy vascular tissue. This new vascular tissue can help restore blood flow and the supply of nutrients to areas of ischemia. The use of iPSCs for angiogenesis also has implications for myocardial infarction as well as organ regeneration (Kawamoto et al., 2013). Stem cells may prove to be a novel and effective approach to the treatment of heart disease in the years to come. Another area of potential interest for therapeutic applications of stem cells is for treatment of heart failure. The transplantation of skeletal myoblasts has been shown to be effective in model rats for congestive heart failure (CHF). Remarkably, reductions in the left ventricular hypertrophy associated with CHF were noted (Durrani et al., 2010). These results suggest that it may be developed into a viable treatment for CHF in the human population. The stem cell therapy may provide benefit through minimizing the compensatory hypertrophy seen in heart failure patients. Other studies have had similar findings as well. In a clinical trial, a treatment called C-Cure (Cardiopoietic stem Cell therapy in heart failure) was used in the treatment of patients with CHF. The patients treated with C-Cure in conjunction with traditional treatment for CHF saw improvements in the left ventricular ejection fraction (LVEF) compared to the control group (Bartunek et al., 2013). With an increased LVEF, the study shows that it may be possible to restore the contractile capacity of the cardiac muscle through stem cell treatments. The results of these studies show promise in the development of more effective treatments of heart failure.
Similar strategies using stem cells have been applied in the case of myocardial infarction. The resulting ischemic damage to the cardiac muscle post-myocardial infarction leads to fibrosis and although it helps to prevent rupture it can create decreased ability of the heart to function (Yamakawa & Idea, 2015). In the case of myocardial infarction, it is important to be able to help support repair while restoring heart function. Fortunately, studies have shown that transplantation of stem cells have effects on neighboring cells through paracrine signaling which reduces apoptosis while promoting angiogenesis and myocardial regeneration (Rasmussen, et al., 2013). This paracrine signaling is of interest when it comes to therapeutic interventions for myocardial infarction. This means that not only might stem cell transplantation into the injured heart help form new heart cells, but it could help minimize cell death in the surrounding area and help the heart repair itself, both of which are issues that need to be addressed post-myocardial infarction. Similar stem cell therapies have showed promise in preventing cell loss and lending structural support to the damaged cardiac tissue (Laake et al., 2006). In relation to the problems associated with fibrosis, reprogramming strategies are suggested to be employed to induce the formation of new cardiomyocytes from fibroblasts (Yamakawa & Idea, 2015). This approach could help the fibroblasts to re-differentiate into functional cardiomyocytes, which could restore function to the infarcted heart. All of the aforementioned applications of stem cells show clinical promise and further research may lead to better prognoses for myocardial infarction. This information on stem cells and their applications would be great information to incorporate into anatomy and physiology lectures on the heart. Stem cell research on cardiac tissue can serve as a nice subtopic and opens opportunities for classroom discussions on how the use of stem cells could affect the structure of diseased cardiac tissue. Presentation of this information will also allow students to apply their knowledge to make educated predictions about how treatment may restore cardiac functionality. Presenting the class with a video on the topic would give a great baseline for students. Following up with a Power Point presentation including research material and various pictures and diagrams would help to consolidate this information into brief, easy to understand sections, ideal for long term retention. Many times, students do not believe all of the information presented to them in the classroom will come into use in their lives. Giving students this real life scenario in which to apply concepts that they have learned throughout the course is a great way to show students that class information is relevant and indeed may be useful to them in many different ways in the future. The topic of stem cell research in the case of cardiac disease also provides an overlap of material that is covered in an anatomy and physiology course. This will help students look at class material as a whole, rather than as a collection of various subtopics.
In conclusion, stem cells show promise in their applications to various heart pathologies. In regards to ischemic heart disease, EPCs were able to restore blood flow through initiating the proliferation of new blood vessels in the areas of ischemia (Webster, 2005). Stem cells have also had some success in the area of congestive heart failure treatments. This is evidenced by the results of the C-Cure clinical trial, which showed increased LVEF in patients treated with the cardiopoietic stem cells (Bartunek et al., 2013). Lastly, myocardial infarction may also be treatable through different variations of stem cell therapy. The paracrine effect that is produced from transplantation of stem cells into the infarcted heart tissue may able to support cell regeneration while minimizing cellular death post-myocardial infarct (Rasmussen, et al., 2013). Overall, the applications of stem cells will be an area of clinical interest in the years to come and further research may lead to the development of safe and effective stem cell treatments for an array of cardiac diseases.

References
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