Exosomes in ischemic heart disease: novel carriers for bioinformation

•Exosomes are implicated in the evolution of ischemic heart disease.•Exosomes mediate cell-to-cell communication by transfer of functional substances such as nucleic acids,proteins,etc.•Cargos carried by exosomes vary with cell origins and disease states, leading to different effects on the recipient cells.•Exosomes act as gene/drug delivery vectors have made some breakthroughs. The occurrence of ischemic heart disease(IHD) is a multi-step chain process from potential risk factors to overt clinical diseases. Vascular cells, blood cells, cardiomyocytes and stem cells are all involved in the pathophysiological links via continual and polynary crosstalk. Exosomes,as powerful vectors for intercellular communication,have been a hotspot for basic and clinical research. Plenty of evidence has shown that exosomes largely participate in the evolution of IHD, including endothelial dysfunction, lipid deposition, atheromatous plaque formation and rupture, myocardial ischemia-reperfusion(I/R) injury,and heart failure (HF), while the rules for detailed communication in the different stages of this continuous disease are still poorly understood. This review will systematically describe characteristics of exosomal crosstalk between different cells in the diverse periods, and also cast light on the potential and challenges for exosome application as therapeutic targets, hoping to offer supporting background for the following research.