Progress on application of exosomes on cardiovascular disease: A ten-year retrospective analysis

Exosomes, nanoscale extracellular vesicles (30-150 nm) carrying bioactive molecules (e.g., miRNAs, proteins), have emerged as pivotal mediators in cardiovascular diseases (CVDs), offering potential as diagnostic biomarkers and therapeutic vectors. Despite growing interest, a comprehensive analysis of global research trends, hotspots, and translational gaps in exosome applications for CVDs remains limited.

We conducted a ten-year (2016-2025) bibliometric analysis of 2617 publications from the Web of Science Core Collection, employing integrative tools (LDGAS and KMVS) to map research distribution, collaborations, and citation trends. Data was analyzed for contributions by country, institution, journal, and author, with a focus on mechanistic insights, clinical applications, and technological innovations.

Global publications surged post-2016, with China leading in output (50 % of top institutions) and the USA/Europe dominating citation impact (e.g., Harvard Medical School: 7.83 citations/paper). Three key themes emerged: exosomal regulation of oxidative stress, inflammation, and angiogenesis; engineered exosomes (e.g., inflammation-targeting macrophage exosomes and stem cell-derived exosomes; circulating miRNAs (e.g., miR-21-5p in heart failure). Challenges include heterogeneous exosome isolation methods (<5 % studies reach preclinical trials) and imbalanced collaborations (China-USA partnerships dominated, 83 %).

Exosome research in CVDs demonstrates transformative potential but requires standardized protocols, diversified clinical trials, and strengthened global partnerships. Prioritizing AI-driven biomarker discovery and interdisciplinary synergy will accelerate clinical translation.