Nanomedicine and Nanotechnology for Heart Failure Research, Diagnosis, and Treatment

Abstract Exponential advances in science and technology are occurring at a breathtaking rate and will revolutionize the understanding of disease and the practice of medicine. Nanotechnology and Nanoscience are central to this revolution and represent a new paradigm of scientific inquiry that has resulted in novel approaches to the study and treatment of disease. “Nano” is Greek for dwarf; in scientific terms it represents a billionth of a unit, the nanometer being the unit associated with this field. As a matter of reference, a human hair is about 100, 000 nm in diameter, a red blood cell 8000 nm, and bacteria are approximately 1000 nm. It is not until the level of individual virus particles (100 nm) or a hemoglobin molecule (5 nm) that we reach the nano level. Nanotechnology can be defined as the study and manipulation of matter at approximately 1–100 nm. It involves modeling, imaging, and measuring at the nano level, with the development of materials, devices, and systems through the manipulation of matter. Nanotechnology is an enabling science that impacts the fields of physics, biology, chemistry, engineering, computer science, materials science, and others. Numerous nano-based products are on the market, from suntan lotion to antibiotics, and hundreds of nano-based companies now exist. The field on nanotechnology got its start in the last century as the atomic theory matured and inventions such as the electron microscope allowed for actual visualization of matter below the limits of the light microscope. In 1959, Richard Feynman, a Nobel laureate in theoretical physics at Cal Tech, gave a lecture titled “There is Plenty of Room at the Bottom.” He asked “What would happen if we could arrange the atoms one by one, the way we want them?” (Engineering and Science, 1960). He is credited with stimulating the next generations of scientists to develop this field. The term nanotechnology was coined by Norio Taniguchi in 1974, with further emphasis and expansion of this field being put forth by Eric Drexler in the 1980's, including a popular book titled, “Engines of Creation: The Coming Era of Nanotechnology.” A number of scientific advances were necessary to allow for the field of nanotechnology to develop. A major advance was the development of the scanning tunneling microscope by researchers at IBM, with the Nobel Prize in physics being awarded for this work in 1986. This device allows for visualization, measurement, and manipulation of individual atoms, a core feature of nanotechnology ( Figure 60.1 , Figure 60.2 ). The US National Nanotechnology Initiative was signed into law in 2001 to encourage the development of nanotechnologies in the United States. Since its inception, in excess of 21 billion dollars have been invested by the Federal Government into numerous departments for nanotechnology research programs (NIH, NSF, DOD, etc.). Nanomedicine is the application of nanotechnologies to the diagnosis, management, and treatment of health and disease. It can be thought of as an entirely new set of tools for both researchers and clinicians and is comprised of hundreds, even thousands of novel technologies that expand our ability to investigate and explore both science and medicine. Nanotechnology and nanoscience are also playing a supportive role in the advancement of regenerative medicine, which will have a major long-term impact on heart failure treatment. This chapter will describe a few of the many types of nano-based technologies that are currently impacting cardiac research and discuss the tools for novel diagnostics, therapeutics, or both (theranostic).