Franklin H. Epstein Lecture: Cardiac Development and Implications for Heart Disease.

Recent studies have revealed a surprising number of previously unappreciated aspects of cardiac morphogenesis that are relevant to both congenital and adult cardiovascular disease. It is now clear that cell populations extrinsic to the primary heart field and the linear heart tube of the embryo contribute to the development of the mature heart and modulate cardiac morphogenesis. These cell populations include neural-crest cells, the cells arising from a second heart field, and epicardial cells. The full developmental potential and unique defining characteristics of various cardiac progenitor cells are only partially known, and specific stages of the progressive lineage restriction of these cardiac progenitors require further characterization. The ability to expand cardiac progenitor populations, either in situ or ex vivo, and to direct cell fate will have important implications for regenerative cardiovascular therapies. The cell biology of myocyte maturation and the effects of the transition from the fetal heart to the adult heart remain areas of investigation that are likely to inform our understanding of heart failure. Studies of the regulation of gene-expression programs in the heart are likely to suggest new therapeutic targets for cardiovascular disease. Copyright © 2010 Massachusetts Medical Society. All rights reserved.