Heart failure (HF) remains a leading cause of mortality, responsible for 13% of all deaths worldwide. The prognosis for patients with HF is poor, with only a 50% survival rate within 5 years. A major challenge of ischaemia-driven HF is the loss of cardiomyocytes, compounded by the minimal regenerative capacity of the adult heart. To date, replacement of irreversibly damaged heart muscle can only be achieved by complete heart transplantation. In the past 20 years, cell therapy has emerged and evolved as a promising avenue for cardiac repair and regeneration. During this time, cell therapy for HF has encountered substantial barriers in both preclinical studies and clinical trials but the field continues to progress and evolve from lessons learned from such research. In this Review, we provide an overview of ongoing trials of cell-based and cell product-based therapies for the treatment of HF. Findings from these trials will facilitate the clinical translation of cardiac regenerative and reparative therapies not only by evaluating the safety and efficacy of specific cell-based therapeutics but also by establishing the feasibility of novel or underexplored treatment protocols such as repeated intravenous dosing, personalized patient selection based on pharmacogenomics, systemic versus intramural cell delivery, and epicardial engraftment of engineered tissue products.

心力衰竭 （HF） 仍然是导致死亡的主要原因，占全球所有死亡人数的 13%。HF 患者的预后较差，5 年内生存率仅为 50%。缺血性 HF 的一个主要挑战是心肌细胞的丢失，再加上成人心脏的再生能力最小。迄今为止，只有通过完全心脏移植才能替代不可逆受损的心肌。在过去的 20 年里，细胞疗法已经出现并发展成为一种有前途的心脏修复和再生途径。在此期间，HF 细胞疗法在临床前研究和临床试验中都遇到了重大障碍，但该领域继续进步并从此类研究中吸取教训。在本综述中，我们概述了正在进行的基于细胞和基于细胞产品的疗法治疗 HF 的试验。这些试验的结果将促进心脏再生和修复疗法的临床转化，不仅通过评估特定基于细胞的疗法的安全性和有效性，而且通过建立新颖或未充分探索的治疗方案的可行性，例如重复静脉给药， 基于药物基因组学、全身细胞递送与壁内细胞递送以及工程组织产品的心外膜植入的个性化患者选择。