Curr Stem Cell Res Ther. 2026 Sep 29. doi: 10.2174/011574888X500658260921112146. Online ahead of print.
ABSTRACT
INTRODUCTION: Cell-based myocardial repair has progressed from direct cell replacement toward paracrine, engineered tissue, and cell-free strategies, but the relationship between preclinical innovation and clinical translation remains unclear. We mapped the knowledge structure and translational trajectory of this field.
METHODS: Original research articles on cell therapy for myocardial infarction or heart failure published from 2004 through 2024 were retrieved from the Web of Science Core Collection. The 1,505 included records were classified as in vitro, animal, or clinical studies; animal and clinical subsets were then compared. Publication, collaboration, co-citation, citation-burst, keyword, and study-type- stratified analyses were performed using VOSviewer, CiteSpace, and the bibliometrix package in R.
RESULTS: Annual output increased from 34 articles in 2004 to a peak of 104 in 2012 and declined to 49 in 2024. The corpus comprised 1,190 animal and 281 clinical studies; clinical output peaked at 26 articles in 2011 and fell to 4 in 2024. The United States and China contributed the most publications, with 82 China-United States collaborations. Co-citation and burst analyses identified early bone marrow- derived and progenitor-cell trials as major intellectual landmarks. Thematic emphasis subsequently shifted toward mesenchymal stromal cells, induced pluripotent stem cell-derived cardiomyocytes, tissue engineering, extracellular vesicles, inflammation, maturation, and electrical integration. Stratified keyword analysis showed that animal studies emphasized mesenchymal stromal cells, cardiomyocytes, and extracellular vesicles. In contrast, clinical studies more often emphasized progenitor cells, bone marrow mononuclear cells, endothelial progenitor cells, and intracoronary delivery.
DISCUSSION: These findings indicate that the field has gradually shifted away from attempts at direct myocardial replacement and toward strategies that emphasize mechanistic understanding, delivery optimization, and paracrine effects. Persistent translational bottlenecks appear to have redirected research priorities across successive phases of cardiac cell therapy development.
CONCLUSION: Preclinical diversification has continued despite contraction of clinical activity, indicating that innovation has outpaced clinical translation. This bibliometric analysis identifies where the animal-clinical gap is concentrated and provides an evidence map for prioritizing reproducible, mechanism-informed, and clinically feasible strategies; it does not establish therapeutic efficacy.
PMID:42817121 | DOI:10.2174/011574888X500658260921112146