Heart failure continues to be one of the leading causes of morbidity and mortality worldwide. Myocardial infarction is the primary causative agent of chronic heart failure resulting in cardiomyocyte necrosis and the subsequent formation of fibrotic scar tissue. Current pharmacological and non-pharmacological therapies focus on managing symptoms of heart failure yet remain unable to reverse the underlying pathology. Heart transplantation usually cannot be relied on, as there is a major discrepancy between the availability of donors and recipients. As a result, heart failure carries a poor prognosis and high mortality rate. As the heart lacks significant endogenous regeneration potential, novel therapeutic approaches have incorporated the use of stem cells as a vehicle to treat heart failure as they possess the ability to self-renew and differentiate into multiple cell lineages and tissues. This review will discuss past, present, and future clinical trials, factors that influence stem cell therapy outcomes as well as ethical and safety considerations. Preclinical and clinical studies have shown a wide spectrum of outcomes when applying stem cells to improve cardiac function. This may reflect the infancy of clinical trials and the limited knowledge on the optimal cell type, dosing, route of administration, patient parameters and other important variables that contribute to successful stem cell therapy. Nonetheless, the field of stem cell therapeutics continues to advance at an unprecedented pace. We remain cautiously optimistic that stem cells will play a role in heart failure management in years to come.

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干细胞治疗心力衰竭：医学突破还是死路一条？

心力衰竭仍然是全世界发病率和死亡率的主要原因之一。心肌梗塞是导致心肌细胞坏死并随后形成纤维化疤痕组织的慢性心力衰竭的主要病因。当前的药物学和非药物学疗法集中于管理心力衰竭的症状，但仍然不能逆转潜在的病理学。通常不能依靠心脏移植，因为供体和接受者的可利用性之间存在重大差异。结果，心力衰竭预后差，死亡率高。由于心脏缺乏明显的内源性再生潜能，由于干细胞具有自我更新和分化为多种细胞谱系和组织的能力，因此新的治疗方法已将干细胞作为治疗心力衰竭的载体。这篇综述将讨论过去，现在和将来的临床试验，影响干细胞治疗结果的因素以及道德和安全考虑。临床前和临床研究已表明，应用干细胞改善心脏功能时可产生多种结果。这可能反映了临床试验的起步阶段以及对最佳细胞类型，给药方式，给药途径，患者参数以及其他有助于成功进行干细胞治疗的重要变量的知识有限。尽管如此，干细胞治疗领域仍以前所未有的速度发展。