Heart regeneration is a remarkable process whereby regrowth of damaged cardiac tissue rehabilitates organ anatomy and function. Unfortunately, the human heart is highly resistant to regeneration, which creates a shortage of cardiomyocytes in the wake of ischemic injury, and explains, in part, why coronary artery disease remains a leading cause of death worldwide. Luckily, a detailed blueprint for achieving therapeutic heart regeneration already exists in nature because several lower vertebrate species successfully regenerate amputated or damaged heart muscle through robust cardiomyocyte proliferation. A growing number of species are being interrogated for cardiac regenerative potential, and several commonalities have emerged between those animals showing high or low innate capabilities. In this review, we provide a historical perspective on the field, discuss how regenerative potential is influenced by cardiomyocyte properties, mitogenic signals, and chromatin accessibility, and highlight unanswered questions under active investigation. Ultimately, delineating why heart regeneration occurs preferentially in some organisms, but not in others, will uncover novel therapeutic inroads for achieving cardiac restoration in humans.

中文翻译：

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心脏再生的先天机制

心脏再生是一个非凡的过程，受损心脏组织的再生可以恢复器官的解剖结构和功能。不幸的是，人类心脏对再生具有高度抵抗力，这会在缺血性损伤后造成心肌细胞短缺，这在一定程度上解释了为什么冠状动脉疾病仍然是全世界死亡的主要原因。幸运的是，自然界中已经存在实现治疗性心脏再生的详细蓝图，因为几种低等脊椎动物物种通过强大的心肌细胞增殖成功地再生了截肢或受损的心肌。越来越多的物种正在接受心脏再生潜力的调查，这些具有高或低先天能力的动物之间出现了一些共性。在这篇综述中，我们提供了该领域的历史视角，讨论了心肌细胞特性、有丝分裂信号和染色质可及性如何影响再生潜力，并强调了积极研究中尚未解答的问题。最终，阐明为什么心脏再生优先发生在某些生物体中而不是其他生物体中，将揭示实现人类心脏恢复的新治疗进展。