Regenerative Stem Cell Therapy Optimization via Tissue Engineering in Heart Failure with Reduced Ejection Fraction

The prevalence of heart failure (HF) is continuously rising in both the industrialized and non-industrialized nations. Despite current therapeutic advances, prognosis of HF patients remains poor. Presently, therapeutic pharmacological and device strategies for HF with reduced ejection fraction (HFrEF) are mostly palliative and do not induce regeneration of lost myocardial tissue. Stem cell therapy has demonstrated promising results in clinical studies by promoting myocardial restoration in HFrEF subjects. Despite decades of investigation, many challenges remain unanswered to the widespread clinical application of stem cell therapy for HFrEF. This review will describe the foundational work already accomplished in cardiac stem cell therapy, advantages and limitations of the various candidates for tissue restoration, their presumed mechanisms of action, the role of scaffolding materials as well as the challenges that exist for widespread clinical application.