Unraveling the Complex Cellular Repair Mechanisms Following Myocardial Infarction

Growing evidence underscores the pivotal roles of both in situ-resident and -non-resident cardiac cells in the repair mechanisms following myocardial infarction (MI). MI continues to be a predominant cause of death and disability, posing a significant threat to global health and well-being. Despite advances in medical care, current therapies remain insufficient in preventing ventricular remodeling and heart failure post-MI. We seek to clarify the underlying regenerative mechanisms by which distinct cell types contribute to the repair of MI injury and to systematically assess the translational potential and therapeutic efficacy of these cell-based approaches in clinical applications. This review conducts a comprehensive analysis of recent research progress on the roles of non-cardiac stem cells in situ and cardiac cells derived from explants in MI repair. These cells contribute to the repair process through multiple mechanisms, including cell proliferation and differentiation, angiogenesis, paracrine signaling, immune regulation and fibrosis modulation. Our analysis reveals the intricate mechanisms of MI repair and highlights the necessity for developing age-specific therapeutic strategies for certain cell types. This review offers novel insights into cell-based treatment for MI and provides a scientific foundation for future clinical trials of cardiac regenerative medicine.