Methods and compositions for treating congestive heart failure

1 . A method of treating a patient suffering from congestive heart failure, comprising contacting a region of the patient's heart with an amount of a cultured three-dimensional tissue that comprises living cells effective to treat at least one clinical symptom associated with heart failure.

2 . The method of claim 1 in which the amount of the cultured three-dimensional tissue is sufficient to improve the pumping efficiency of the heart.

3 . The method of claim 2 in which the pumping efficiency of the heart is measured by the ejection fraction.

4 . The method of claim 1 in which the amount of the cultured three-dimensional tissue is sufficient to improve the contractility of the heart.

5 . The method of claim 1 in which the amount of the cultured three-dimensional tissue is sufficient to reduce the size of the heart.

6 . The method of claim 1 in which the damaged heart tissue is contacted with a first and at least a second cultured three-dimensional tissue.

7 . The method of claim 1 in which the damaged heart tissue is contacted concurrently with said first and at least a second cultured three-dimensional tissues.

8 . The method of claim 1 in which the living cells comprise fibroblasts.

9 . The method of claim 1 in which the living cells comprise smooth muscle cells.

10 . The method of claim 9 in which the smooth muscle cells are vascular smooth muscle cells.

11 . The method of claim 10 in which the vascular smooth muscle cells are aortic smooth muscle cells.

12 . The method of claim 1 in which the living cells comprise cardiac muscle cells.

13 . The method of claim 1 in which the living cells comprise stem cells.

14 . The method of claim 1 in which the living cells comprise a plurality of cell types, the plurality of cell types selected from the group consisting of fibroblasts, smooth muscle cells, cardiac muscle cells, endothelial cells, stem cells, pericytes, macrophages, monocytes, leukocytes, plasma cells, mast cells and adipocytes.

15 . The method of claim 1 in which the region of the patient's heart is the epicardium.

16 . The method of claim 1 in which the region of the patient's heart is the myocardium.

17 . The method of claim 1 in which the region of the patient's heart is the endocardium.

18 - 19 . (canceled)

20 . The method of claim 1 , further comprising administering a therapeutically effective amount of one or more angiotensin-converting enzyme (ACE) inhibitors.

21 . The method of claim 1 , further comprising administering a therapeutically effective amount of one or more angiotensin II (A-II) receptor blockers.

22 . The method of claim 1 , further comprising administering a therapeutically effective amount of a diuretic.

23 . The method of claim 1 , further comprising administering a therapeutically effective amount of digoxin.

24 . The method of claim 1 , further comprising administering a therapeutically effective amount of a beta blocker.

25 . The method of claim 1 , further comprising administering a therapeutically effective amount of nesiritide.

26 . The method of claim 1 , further comprising the implantation of a mechanical device into the patient.

27 . The method of claim 1 , further comprising wrapping the patient's heart with a mesh bag.

28 . The method of claim 1 , in which the cells of the cultured three-dimensional tissue are attached to a substrate comprising a biodegradable material.

29 . The method of claim 28 in which the biodegradable material comprises trimethylene carbonate, polyglycolic acid, polylactide, polylactide-co-glycolic acid, catgut sutures, cellulose, gelatin, collagen, and/or dextran.

30 . The method of claim 1 , in which the cells of the cultured three-dimensional tissue are attached to a substrate comprising a non-biodegradable material.

31 . The method of claim 30 in which the non-biodegradable material comprises a polyamide, a polyester, a polystryrene, a polypropylene, a polyacrylate, a polyvinvyl, a polycarbonate, a polytetrafluorethylene, a nitrocellulose compound and/or cotton.

32 . The method of claim 1 , in which the cells of the cultured three-dimensional tissue are attached to microparticles.

33 . The method of claim 1 , comprising attaching the cultured three-dimensional cells to the region of the heart using a mechanical and/or biological means.

34 . The method of claim 29 in which the biodegradable material comprises copolymers of trimethylene carbonate, polyglycolic acid, polylactide.