Mesenchymal Stem Cell Therapy for Patients with Ischemic Heart Failure- Past, Present, and Future

The prevalence of Heart Failure (HF) has increased over time. Ischemic heart failure accounts for 50% of HF, which results from ischemic coronary heart diseases such as Myocardial Infarction (MI). Conventionally, reduction of cardiac load and revascularization partially increase cardiomyocyte survival and preserve cardiac functions. Nevertheless, how to improve cardiomyocyte rescue and prevent HF progression remain as challenges. Mesenchymal Stem Cells (MSCs) are multipotent stem cells that give rise to various lineages. The administration of MSCs promotes cardiomyocyte survival and improves cardiac functions in animal models of MI and patients with ischemic cardiomyopathy. However, after injection, MSCs persist for a very short time, indicating that the prolonged protective effects of MSCs on cardiomyocytes may be mediated by paracrine functions of MSCs, such as exosomes. In this review, we focus on MSC-derived exosomes in cardiomyocyte protection to facilitate future applications of exosomes in HF treatment.