Another futuristic option in the setting of HFpEF is the potential use of stem cells – recently, in the animal model of diabetic cardiomyopathy, a disease phenotype which is very similar to HFpEF, bilayer of smooth muscle cells and endothelial progenitor cells, obtained from engineered bone marrow mesenchymal cells in rats, and implanted on the left ventricle, led to a preserved microvascular function through increased VEGF, decreased TGF-β and caspases expression, thus diminishing interstitial fibrosis while increasing microvascular density (Kawamura et al., 2017). This evidence concerns the gene TGFB1 and diabetic cardiomyopathy.