181 © Springer Nature Switzerland AG 2018 A. Giuliani, A. Cedola (eds.), Advanced High-Resolution Tomography in Regenerative Medicine, Fundamental Biomedical Technologies, https://doi.org/10.1007/978-3-030-00368-5_12 Chapter 12 Into the Heart: What Contributions to Cardiac Regeneration? Alessandra Giuliani and Mara Mencarelli Abstract One of the leading causes of death in the western world is undoubtedly cardiovascular diseases, with special reference to myocardial infarction and conse- quent heart failure. The therapeutic strategies adopted nowadays are based on drug therapy, coronary artery angioplasty, pacemakers and implantable defbrillator, cor- onary artery bypass grafts, ventricular remodeling, dynamic cardiomyoplasty, organ transplantation, and mechanical circulatory assistance devices. However, all these procedures are often ineffective and invasive. Moreover, myocardial heart engineer- ing has experienced signifcant progress over the last 10 years, with fundamental advances in stem cell biology and knowledge of biomaterials. However, one of the limiting factors in the overall interpretation of clinical results obtained by cell ther- apy is represented by the lack of in vivo visualization of the injected cells and of their fate within the myocardium. This chapter shows that X-ray microtomography (microCT) and in particular phase-contrast imaging may offer the unique possibility to detect with high defnition and resolution the three-dimensional spatial distribu- tion of stem cells, once injected inside an infarcted heart in small animal models. It was shown, through microCT, the migration of these cells within the damaged car- diac tissue, achieving an appropriate identifcation and localization of the injected cells. Thus, phase-contrast microCT appears to be an innovative and exclusive way to investigate the cellular events involved in cardiac regeneration and represents a promising tool for future clinical translations. 1 Introduction One of the leading causes of death in the western world is undoubtedly cardiovas- cular diseases (CVDs), with special reference to myocardial infarction (MI) and consequent heart failure (HF) [1–3], caused by irreparable loss or dysfunction of A. Giuliani (*) · M. Mencarelli Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy e-mail: a.giuliani@univpm.it