Authored by Gladstone Institute of Cardiovascular Disease Director Deepak Srivastava, MD, and Gladstone Institutes postdoctoral scholar Kathryn Ivey, PhD, the paper cites a better understanding of the following areas of research:

• the developmental processes within the heart that can be reproduced using pluripotent embryonic stem cells (these are early stem cells that can grow into almost any cell type)

• the cues that control multipotent cardiac stem cells (these stem cells, which have less developmental potential than embryonic stem cells, produce different types of cells that make up the heart)

• the ability of circulating progenitor cells (early-stage cells that have not yet differentiated, or specialized) to produce factors that are sufficient to invoke cell survival or repair responses in damaged heart cells

"The use of stem cells to generate replacement cells for damaged heart muscle, valves, vessels and conduction cells holds great potential," says Srivastava, who is also a UCSF professor of pediatrics and the Wilma and Adeline Pirag Distinguished Professor in Pediatric Developmental Cardiology. "Although there are clearly many obstacles to overcome, it is significant that a roadmap of the derivation and use of stem cells for human heart disease is now conceivable."

In the Nature article, Srivastava and Ivey point to several challenges ahead:

• Developing the ability not only to guide and expand stem cells into the cardiac lineage but also to repress alternative cell fates

• Developing methods for safe delivery and proper integration of stem cells within patients' heart tissue to avoid such complications as arrhythmias (irregular heart beat)

• Solving immunological issue
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