After two decades of intensive research and attempts of clinical translation, stem cell based therapies for cardiac diseases are not getting closer to clinical success. This review tries to unravel the obstacles and focuses on underlying mechanisms as the target for regenerative therapies. At present, the principal outcome in clinical therapy does not reflect experimental evidence. It seems that the scientific obstacle is a lack of integration of knowledge from tissue repair and disease mechanisms. Recent insights from clinical trials delineate mechanisms of stem cell dysfunction and gene defects in repair mechanisms as cause of atherosclerosis and heart disease. These findings require a redirection of current practice of stem cell therapy and a reset using more detailed analysis of stem cell function interfering with disease mechanisms. To accelerate scientific development the authors suggest intensifying unified computational data analysis and shared data knowledge by using open-access data platforms.

经过二十多年的深入研究和临床翻译尝试，基于干细胞的心脏病治疗方法离临床成功越来越近。这项审查试图消除障碍，并着重于作为再生疗法目标的潜在机制。目前，临床治疗的主要结局尚无实验证据。似乎科学的障碍是缺乏来自组织修复和疾病机制的知识整合。来自临床试验的最新见解描述了干细胞功能障碍的机制和修复机制中的基因缺陷，这些都是动脉粥样硬化和心脏病的原因。这些发现需要重新引导干细胞治疗的当前实践，并使用更详细的干细胞功能干扰疾病机制的分析方法进行复位。