Mechanical unloading and cell therapy have a synergistic role in the recovery and regeneration of the failing heart.

The problem of a growing patient population with end-stage heart failure and a fixed cardiac donor pool has stimulated the development of novel therapies for heart failure. Two therapeutic strategies have emerged with the potential to improve the landscape of the clinical management of heart failure. First, left ventricular assist device therapy is able to sustain the circulation of patients in end-stage heart failure and may promote cardiac recovery. Secondly, stem cell therapy can potentially be used to induce myocardial regeneration replacing lost or non-functioning native myocardium. In this review, we present evidence that these strategies may overlap significantly in their mechanisms of action at the systems, organ, tissue and cellular levels. We review the current clinical evidence of their combined use.