Table 1.

Gene transfer vectors used in heart gene therapy

Vector for gene delivery	Delivery methods	Length of gene expression	Advantages	Disadvantages	References
Nonviral
Plasmids	Intramyocardial	28–60 days	Low cost, simplicity in design	Restricted transduction, short-term expression	1–12
DNA–lipid complexes	Intravenous		Ability to deliver systemically	Limited myocardial transduction, off-target expression	13–17
Oligonucleotides	Intravenous	2 weeks to 3 months	Restore expression at mRNA level	Repeated administration, short half-life, patient-specific design	18–19
Viral
Lentivirus	Intramyocardial, coronary arterial	10 weeks to 6 months	Ability to package up to 8 kb, persistent expression upon integration to the host genome	Myocardial inflammation, insertional mutagenesis	21–24
Adenovirus	Intramyocardial, intrapericardial, coronary arterial, intravenous	1–8 weeks	Large packaging capacity (up to 35 kb for gutted adenovirus), efficient cardiomyocyte transduction	Myocardial inflammation, cellular immune responses	25–41
Adeno-associated virus	Intramyocardial, intrapericardial, coronary arterial, intravenous	5 weeks to 12 months	Efficient cardiomyocyte transduction, persistent expression	Limited packaging capacity	42–74