The prevalence of Heart Failure (HF) has increased over time. Ischemic heart failure accounts
for 50% of HF, which results from ischemic coronary heart diseases such as Myocardial Infarction
(MI). Conventionally, reduction of cardiac load and revascularization partially increase cardiomyocyte
survival and preserve cardiac functions. Nevertheless, how to improve cardiomyocyte rescue
and prevent HF progression remain as challenges. Mesenchymal Stem Cells (MSCs) are multipotent
stem cells that give rise to various lineages. The administration of MSCs promotes cardiomyocyte survival
and improves cardiac functions in animal models of MI and patients with ischemic cardiomyopathy.
However, after injection, MSCs persist for a very short time, indicating that the prolonged protective
effects of MSCs on cardiomyocytes may be mediated by paracrine functions of MSCs, such as
exosomes. In this review, we focus on MSC-derived exosomes in cardiomyocyte protection to facilitate
future applications of exosomes in HF treatment.