Hydrogels for Cardiac Tissue Repair and Regeneration

Abstract

The main cause of death in the world continues to be cardiovascular disease, which affects annually over 900,000 people and in the entire word approximately 50% of the people suffering myocardial infarction (MI) die within 5 years. MI causes a number of cardiac pathologies like hypertension, blocked coronary arteries and valvular heart diseases resulting ischemic cardiac injury. In the last years, cardiac tissue engineering has made considerable progress, because this progress have been made towards developing injectable hydrogels for the purpose of cardiac repair and/or regeneration. This study aims to provide an updated survey of the major progress in the fl ied of injectable cardiac tissue engineering, including biomaterials (natural, synthetic or hybrid hydrogels), their advantages or disadvantages and the main seeding cell sources. Also, this review focuses on the progress made in the fi eld of hydrogels for cardiac tissue repair and/or regeneration for MI over the last years.

A bioresorbable biomaterial carrier and passive stabilization device to improve heart function post-myocardial infarction

“…PEUU was chosen as material for SPREADS due to its suitable mechanical properties (adequate stiffness, flexibility, structural integrity), processability (to meet the structural design features of SPREADS), expected biocompatibility and biodegradability. Adequate conformity of mechanical support devices with the healthy myocardium in terms of mechanical properties is essential to successfully transfer stress from the infarcted myocardium and border zone while preserving the native cardiac contractility [4,6,22]. However, former whole heart passive restraint devices [4] are characterized by a much higher stiffness than the native myocardium at the end of the systole, such as 500 kPa [22], and as a result impair diastolic function of the right ventricle [65].…”

“…Adequate conformity of mechanical support devices with the healthy myocardium in terms of mechanical properties is essential to successfully transfer stress from the infarcted myocardium and border zone while preserving the native cardiac contractility [4,6,22]. However, former whole heart passive restraint devices [4] are characterized by a much higher stiffness than the native myocardium at the end of the systole, such as 500 kPa [22], and as a result impair diastolic function of the right ventricle [65]. Chitsaz, Wenk [65] determined that the CorCap device has a minimal stiffness of 3 MPa in its cross-fiber direction.…”

“…Numerous natural and synthetic biodegradable materials have been investigated for cell-free approaches to mechanically reinforce the infarcted myocardium [14,21], as carrier material for cellbased regenerative strategies [11,22] and therapeutic agent delivery [23][24][25][26]. Natural materials are preferred in terms of cell and tissue compatibility provoking less cytotoxic effects and reducing the possibility of an immune response when implanted in vivo.…”

“…However, most natural materials lack adequate mechanical properties such as sufficient stiffness to provide ample mechanical support [36] and stability towards the frictional stress caused by the relative movement of the pericardium [22] negating their potential as epicardial patch materials.…”

“…In this case SPREADS successfully delivered a cell-loaded HA-PH-RGD hydrogel whose mechanical properties and degradation rate can be customised by altering its cross-linking concentration. The SPREADS device could potentially be used to deliver a range of biomaterial hydrogels [22] previously reported, which could swiftly overcome translational hurdles associated with hydrogel delivery to the heart.…”