Mesenchymal Stromal Cell Therapy in Cardiovascular Disease: Reconsidering Clinical Inconsistency Through the Mechanism-Endpoint Relationship.

Mesenchymal stromal cell (MSC) therapy has been investigated for more than two decades as a regenerative approach in cardiovascular disease. Preclinical studies have shown reproducible biological activity; however, clinical translation has been less convincing. Trials in acute myocardial infarction (AMI) and heart failure (HF) have established feasibility and an acceptable safety profile; however, effects on functional and imaging parameters remain modest, and a consistent impact on mortality, hospitalization, and other hard clinical outcomes has not been demonstrated.