
This review discusses the significant loss of cardiomyocytes following a myocardial infarction, with residual ischemia leading to further damage and functional decline. While current treatments have not effectively increased vascularization in the infarcted heart, new approaches targeting the perivascular niche offer potential solutions. The perivascular environment contains essential cell types like pericytes that play crucial roles in angiogenesis, scar formation, and inflammatory response control. Pericyte-based therapies, including exogenous pericytes, pericyte-derived exosomes, engineered biomaterials, and pharmacological approaches, show promise in restoring the perivascular niche after myocardial infarction. Promising preclinical results suggest pericytes could be pivotal in treating coronary artery disease and preventing post-ischemic heart failure.
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