Exosomes are bilayer membrane vesicles with cargos that contain a variety of surface proteins, markers, lipids, nucleic acids, and noncoding RNAs. Exosomes from different cardiac cells participate in the processes of cell migration, proliferation, apoptosis, hypertrophy, and regeneration, as well as angiogenesis and enhanced cardiac function, which accelerate cardiac repair. In this article, we mainly focused on the exosomes from six main types of cardiac cells, i.e., fibroblasts, cardiomyocytes, endothelial cells, cardiac progenitor cells, adipocytes, and cardiac telocytes. This may be the first article to describe the commonalities and differences in regard to the function and underlying mechanisms of exosomes among six cardiac cell types in cardiovascular disease.

AimsWe sought to determine whether repeat administration of bone marrow mononuclear cells (BMC) can improve left ventricular function compared with a single infusion in patients with large acute myocardial infarction (AMI). Methods and resultsThirty-nine patients with a ST-elevation AMI of the anterior wall and a significantly decreased left ventricular ejection fraction (LVEF 20-39%) were randomly assigned to three groups following primary percutaneous coronary intervention: Group A (n ¼ 12) received a single intracoronary infusion of BMC (1.9 + 1.2 Â 10 8 ) at 3-7 days after AMI; Group B (n ¼ 15) received BMC administration both at 3-7 days (2.0 + 1.4 Â 10 8 ) and at 3 months (2.1 + 1.7 Â 10 8 ); and the control group (CON, n ¼ 12) received one placebo injection at 3 -7 days. We noted no severe complications associated with the BMC transfer. The increase in LVEF evaluated by magnetic resonance imaging (MRI) after 12 months in Group B (11.7 + 2.6%) was significantly greater than that in Group A (7.2 + 1.6%, P , 0.001) or in CON (2.9 + 2.0%, P , 0.001). Magnetic resonance imaging-derived myocardial infarct size decreased significantly in Group B compared with Group A (11.3 + 2.7% vs. 6.3 + 1.6%, P , 0.001). ConclusionData from this preliminary study suggest that repeated BMC administration might be a safe and feasible therapeutic strategy for patients with large AMI.--