Regenerative cell imaging in cardiac repair.

Heart disease continues to be a leading cause of death in the Western world. Although strides have been made in prevention and management of coronary artery disease, lost myocardium after an ischemic event remains at the core of the morbidity and the mortality. Poor regenerative capacity of the myocardium has led to the study of cell-based therapies to restore anatomical, functional, and viable myocardium. To that end, stem cells are undifferentiated cells that are self-renewing, clonogenic, and pluripotent and therefore ideal for the restorative job. However, to refine the technique of cell-based therapy, in vivo molecular assessment is imperative to monitor cell survival and their effect on myocardial restoration. Direct imaging of the behaviour of cells after implantation into living subjects can offer great insight into their mechanisms of action, and their therapeutic efficacy. In this article we explore current knowledge of various imaging modalities that have been used to assess in vivo cellular and molecular events after administration of stem cells in injured myocardium. The goal of the article is to provide a comprehensive overview of the literature, highlight various imaging modalities, and suggest some of the key concepts on the horizon in cardiac stem cell imaging.