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good morning everyone thank or giving me this opportunity this morning Ill be discussing this morning I think we have a sort of notion of how the failing myocardial has dysfunctional cardiac cells fibroblasts that are expanding due to infarct sore dead cells and progenitor cells that can have the ability to induce proliferation of cardiac myocytes or have paracrine effects on them now over the years theres been a lot of work on stem cell to replace the dead zones however gene therapy really concerns itself with how to improve cardiac cell function using our knowledge of whats wrong with in the cardiac cell so heres a schematic of excitation contraction coupling in cardiac cells and some of the areas that have been known to be abnormal in heart failure including calcium cycling beta adrenergic signaling a number of pathways for hypertrophic responses and a lot of work has been done on how to improve for example calcium cycling winding a receptor dysfunction with leaks of calcium fr