Regenerative strategies for myocardial infarction: Integrating cell therapy and scaffold design

One of the most common causes of death in the world is myocardial infarction (MI), and its standard treatment fails to renew the injured cardiac tissue completely. Regenerative medicine has also emerged as a promising avenue for myocardial restoration, with stem cell therapy, scaffold engineering, and cell-seeded biomaterials showing potential in preliminary investigations and initial clinical practice. This paper will explore the various restorative options for MI repair, specifically stem cells, including mesenchymal stem cells (MSCs), induced pluripotent stem cells (iPSCs), and cardiac progenitor cells (CPCs), as well as their applications in conjunction with the use of biomaterial scaffolds. Vital stem cell therapies have been shown to exhibit their paracrine effects, promote angiogenesis, and directly differentiate into cardiomyocytes. Additionally, scaffold designs such as bioactive scaffolds and 3D bioprinting enhance cell survival and promote their incorporation into the infarcted myocardium. The shortcomings, including poor cell engraftment, lack of immunological response, tumor growth, and a lack of long-term safety, are critically evaluated in this review. However, there is also the potential breakthrough of stem cells combined with scaffolds. Lastly, the paper projects future avenues in myocardial regeneration, such as the use of gene-editing tools, personalized medicine, and wearable biosensors with the ability to monitor in real-time. Overall, regenerative therapies hold great promise for improving myocardial function and restoring heart tissue, but clinical translation remains a significant hurdle.