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Liu T, Hao Y, Zhang Z, Zhou H, Peng S, Zhang D, Li K, Chen Y, Chen M. Advanced Cardiac Patches for the Treatment of Myocardial Infarction. Circulation 2024; 149:2002-2020. [PMID: 38885303 DOI: 10.1161/circulationaha.123.067097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Myocardial infarction is a cardiovascular disease characterized by a high incidence rate and mortality. It leads to various cardiac pathophysiological changes, including ischemia/reperfusion injury, inflammation, fibrosis, and ventricular remodeling, which ultimately result in heart failure and pose a significant threat to global health. Although clinical reperfusion therapies and conventional pharmacological interventions improve emergency survival rates and short-term prognoses, they are still limited in providing long-lasting improvements in cardiac function or reversing pathological progression. Recently, cardiac patches have gained considerable attention as a promising therapy for myocardial infarction. These patches consist of scaffolds or loaded therapeutic agents that provide mechanical reinforcement, synchronous electrical conduction, and localized delivery within the infarct zone to promote cardiac restoration. This review elucidates the pathophysiological progression from myocardial infarction to heart failure, highlighting therapeutic targets and various cardiac patches. The review considers the primary scaffold materials, including synthetic, natural, and conductive materials, and the prevalent fabrication techniques and optimal properties of the patch, as well as advanced delivery strategies. Last, the current limitations and prospects of cardiac patch research are considered, with the goal of shedding light on innovative products poised for clinical application.
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Affiliation(s)
- Tailuo Liu
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases (T.L., Y.H., H.Z., S.P., D.Z., Y.C., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
- Department of Cardiology (T.L., S.P., D.Z., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
- Medicine and Engineering Interdisciplinary Research Laboratory of Nursing & Materials, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China (T.L., K.L., Y.C.)
| | - Ying Hao
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases (T.L., Y.H., H.Z., S.P., D.Z., Y.C., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
| | - Zixuan Zhang
- West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, PR China (Z.Z.)
| | - Hao Zhou
- Laboratory of Cardiac Structure and Function, Institute of Cardiovascular Diseases (T.L., Y.H., H.Z., S.P., D.Z., Y.C., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
| | - Shiqin Peng
- Department of Cardiology (T.L., S.P., D.Z., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
| | - Dingyi Zhang
- Department of Cardiology (T.L., S.P., D.Z., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
| | - Ka Li
- Medicine and Engineering Interdisciplinary Research Laboratory of Nursing & Materials, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China (T.L., K.L., Y.C.)
| | - Yuwen Chen
- Medicine and Engineering Interdisciplinary Research Laboratory of Nursing & Materials, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China (T.L., K.L., Y.C.)
| | - Mao Chen
- Department of Cardiology (T.L., S.P., D.Z., M.C.), West China Hospital, Sichuan University, Chengdu, PR China
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Cardiac support device (ASD) delivers bone marrow stem cells repetitively to epicardium has promising curative effects in advanced heart failure. Biomed Microdevices 2018; 20:40. [DOI: 10.1007/s10544-018-0282-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Naveed M, Mohammad IS, Xue L, Khan S, Gang W, Cao Y, Cheng Y, Cui X, DingDing C, Feng Y, Zhijie W, Xiaohui Z. The promising future of ventricular restraint therapy for the management of end-stage heart failure. Biomed Pharmacother 2018; 99:25-32. [PMID: 29324309 DOI: 10.1016/j.biopha.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 01/31/2023] Open
Abstract
Complicated pathophysiological syndrome associated with irregular functioning of the heart leading to insufficient blood supply to the organs is linked to congestive heart failure (CHF) which is the leading cause of death in developed countries. Numerous factors can add to heart failure (HF) pathogenesis, including myocardial infarction (MI), genetic factors, coronary artery disease (CAD), ischemia or hypertension. Presently, most of the therapies against CHF cause modest symptom relief but incapable of giving significant recovery for long-term survival outcomes. Unfortunately, there is no effective treatment of HF except cardiac transplantation but genetic variations, tissue mismatch, differences in certain immune response and socioeconomic crisis are some major concern with cardiac transplantation, suggested an alternate bridge to transplant (BTT) or destination therapies (DT). Ventricular restraint therapy (VRT) is a promising, non-transplant surgical treatment wherein the overall goal is to wrap the dilated heart with prosthetic material to mechanically restrain the heart at end-diastole, stop extra remodeling, and thereby ultimately improve patient symptoms, ventricular function and survival. Ventricular restraint devices (VRDs) are developed to treat end-stage HF and BTT, including the CorCap cardiac support device (CSD) (CSD; Acorn Cardiovascular Inc, St Paul, Minn), Paracor HeartNet (Paracor Medical, Sunnyvale, Calif), QVR (Polyzen Inc, Apex, NC) and ASD (ASD, X. Zhou). An overview of 4 restraint devices, with their precise advantages and disadvantages, will be presented. The accessible peer-reviewed literature summarized with an important considerations on the mechanism of restraint therapy and how this acquaintance can be accustomed to optimize and improve its effectiveness.
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Affiliation(s)
- Muhammad Naveed
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Imran Shair Mohammad
- Department of Pharmaceutics, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Li Xue
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Sara Khan
- Department of Pharmaceutical Chemistry, University College of Pharmacy, University of the Punjab, Lahore 5400, Pakistan
| | - Wang Gang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Yanfang Cao
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Yijie Cheng
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Xingxing Cui
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China
| | - Chen DingDing
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China.
| | - Yu Feng
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China.
| | - Wang Zhijie
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, PR China.
| | - Zhou Xiaohui
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy China Pharmaceutical University, School of Pharmacy, Jiangsu Province, Nanjing 211198, PR China; Department of Heart Surgery, Nanjing Shuiximen Hospital, Jiangsu Province, Nanjing 210017, PR China; Department of Cardiothoracic Surgery, Zhongda Hospital affiliated to Southeast University, Jiangsu Province, Nanjing 210017, PR China.
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Naveed M, Wenhua L, Gang W, Mohammad IS, Abbas M, Liao X, Yang M, Zhang L, Liu X, Qi X, Chen Y, Jiadi L, Ye L, Zhijie W, Ding CD, Feng Y, Xiaohui Z. A novel ventricular restraint device (ASD) repetitively deliver Salvia miltiorrhiza to epicardium have good curative effects in heart failure management. Biomed Pharmacother 2017; 95:701-710. [PMID: 28886530 DOI: 10.1016/j.biopha.2017.07.126] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/24/2017] [Accepted: 07/24/2017] [Indexed: 11/20/2022] Open
Abstract
A novel ventricular restraint is the non-transplant surgical option for the management of an end-stage dilated heart failure (HF). To expand the therapeutic techniques we design a novel ventricular restraint device (ASD) which has the ability to deliver a therapeutic drug directly to the heart. We deliver a Traditional Chinese Medicine (TCM) Salvia miltiorrhiza (Danshen Zhusheye) through active hydraulic ventricular support drug delivery system (ASD) and we hypothesize that it will show better results in HF management than the restraint device and drug alone. SD rats were selected and divided into five groups (n=6), Normal, HF, HF+SM (IV), HF+ASD, HF+ASD+SM groups respectively. Post myocardial infarction (MI), electrocardiography (ECG) showed abnormal heart function in all groups and HF+ASD+SM group showed a significant therapeutic improvement with respect to other treatment HF, HF+ASD, and HF+SM (IV) groups on day 30. The mechanical functions of the heart such as heart rate, LVEDP, and LVSP were brought to normal when treated with ASD+SM and show significant (P value<0.01) compared to other groups. BNP significantly declines in HF+ASD+SM group animals compared with other treatment groups. Masson's Trichrome staining was used to study histopathology of cardiac myocytes and quantification of fibrosis was assessed. The large blue fibrotic area was observed in HF, HF+ASD, and HF+SM (IV) groups while HF+ASD+SM showed negligible fibrotic myocyte at the end of study period (30days). This study proves that novel ASD device augments the therapeutic effect of the drug and delivers Salvia miltiorrhiza to the cardiomyocytes significantly as well as provides additional support to the dilated ventricle by the heart failure.
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Affiliation(s)
- Muhammad Naveed
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China; Department of Surgery, Aviation General Hospital, Beijing, 100012, PR China
| | - Li Wenhua
- Department of Surgery, Aviation General Hospital, Beijing, 100012, PR China
| | - Wang Gang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China
| | - Imran Shair Mohammad
- Department of Pharmaceutics, School of Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China
| | - Muhammad Abbas
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China
| | - Xiaoqian Liao
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China
| | - Mengqi Yang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China
| | - Li Zhang
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China
| | - Xiaolin Liu
- Children's Hospital of Zhengzhou, Zhengzhou, Henan Province, 450053, PR China
| | - Xiaoming Qi
- University of Traditional Chinese Medicine, Taiyuan, Shanxi Province, 030600, PR China
| | - Yineng Chen
- Department of National Training Base for Talents in Life Science and Technology, School of Life Science and Technology, China Pharmaceutical University, Nanjing, Jiangsu Province, 211198, PR China
| | - Lv Jiadi
- Department of Immunology, Peking Union Medical College, Beijing, 100032, PR China
| | - Linlan Ye
- Department of Pharmaceutical Preparation Section, The 3rd Peoples of Wuxi, Wuxi, Jiangsu Province, 214000, PR China
| | - Wang Zhijie
- Key Laboratory of Semiconductor Materials Science, Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, PR China.
| | - Chen Ding Ding
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China.
| | - Yu Feng
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China.
| | - Zhou Xiaohui
- Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, School of Pharmacy, Jiangsu Province, 211198, PR China; Department of Heart Surgery, Nanjing Shuiximen Hospital, Nanjing, Jiangsu Province, 210017, PR China; Deprtment of Cardiothoracic Surgery, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu Province, 210017, PR China.
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Fischer KM, Morgan KY, Hearon K, Sklaviadis D, Tochka ZL, Fenton OS, Anderson DG, Langer R, Freed LE. Poly(Limonene Thioether) Scaffold for Tissue Engineering. Adv Healthc Mater 2016; 5:813-21. [PMID: 26890480 PMCID: PMC4828277 DOI: 10.1002/adhm.201500892] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Indexed: 01/14/2023]
Abstract
A photocurable thiol-ene network polymer, poly(limonene thioether) (PLT32o), is synthesized, characterized, fabricated into tissue engineering scaffolds, and demonstrated in vitro and in vivo. Micromolded PLT32o grids exhibit compliant, elastomeric mechanical behavior similar to grids made of poly(glycerol sebacate) (PGS), an established biomaterial. Multilayered PL32o scaffolds with regular, geometrically defined pore architectures support heart cell seeding and culture in a manner similar to multilayered PGS scaffolds. Subcutaneous implantation of multilayered PLT32o scaffolds with cultured heart cells provides long-term 3D structural support and retains the exogenous cells, whereas PGS scaffolds lose both their structural integrity and the exogenous cells over 31 d in vivo. PLT32o membrane implants retain their dry mass, whereas PGS implants lose 70 percent of their dry mass by day 31. Macrophages are initially recruited to PLT32o and PGS membrane implants but are no longer present by day 31. Facile synthesis and processing in combination with the capability to support heart cells in vitro and in vivo suggest that PLT32o can offer advantages for tissue engineering applications where prolonged in vivo maintenance of 3D structural integrity and elastomeric mechanical behavior are required.
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Affiliation(s)
- Kristin M Fischer
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Kathy Ye Morgan
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Keith Hearon
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Demetra Sklaviadis
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Zachary L Tochka
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Owen S Fenton
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Daniel G Anderson
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Robert Langer
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Lisa E Freed
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Researchand Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Materials Engineering Division, Draper, Cambridge, MA, 02139, USA
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Impact of cardiac support device combined with slow-release prostacyclin agonist in a canine ischemic cardiomyopathy model. J Thorac Cardiovasc Surg 2014; 147:1081-7. [DOI: 10.1016/j.jtcvs.2013.05.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/09/2013] [Accepted: 05/16/2013] [Indexed: 01/29/2023]
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Neal RA, Jean A, Park H, Wu PB, Hsiao J, Engelmayr GC, Langer R, Freed LE. Three-dimensional elastomeric scaffolds designed with cardiac-mimetic structural and mechanical features. Tissue Eng Part A 2012. [PMID: 23190320 DOI: 10.1089/ten.tea.2012.0330] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Tissue-engineered constructs, at the interface of material science, biology, engineering, and medicine, have the capacity to improve outcomes for cardiac patients by providing living cells and degradable biomaterials that can regenerate the native myocardium. With an ultimate goal of both delivering cells and providing mechanical support to the healing heart, we designed three-dimensional (3D) elastomeric scaffolds with (1) stiffnesses and anisotropy mimicking explanted myocardial specimens as predicted by finite-element (FE) modeling, (2) systematically varied combinations of rectangular pore pattern, pore aspect ratio, and strut width, and (3) structural features approaching tissue scale. Based on predicted mechanical properties, three scaffold designs were selected from eight candidates for fabrication from poly(glycerol sebacate) by micromolding from silicon wafers. Large 20×20 mm scaffolds with high aspect ratio features (5:1 strut height:strut width) were reproducibly cast, cured, and demolded at a relatively high throughput. Empirically measured mechanical properties demonstrated that scaffolds were cardiac mimetic and validated FE model predictions. Two-layered scaffolds providing fully interconnected pore networks were fabricated by layer-by-layer assembly. C2C12 myoblasts cultured on one-layered scaffolds exhibited specific patterns of cell elongation and interconnectivity that appeared to be guided by the scaffold pore pattern. Neonatal rat heart cells cultured on two-layered scaffolds for 1 week were contractile, both spontaneously and in response to electrical stimulation, and expressed sarcomeric α-actinin, a cardiac biomarker. This work not only demonstrated several scaffold designs that promoted functional assembly of rat heart cells, but also provided the foundation for further computational and empirical investigations of 3D elastomeric scaffolds for cardiac tissue engineering.
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Affiliation(s)
- Rebekah A Neal
- Harvard-MIT Division of Health Sciences and Technology, David H. Koch Institute for Integrative Cancer Research, and Institute for Medical Engineering and Science, Massachusetts Institute of Technology , Cambridge, Massachusetts, USA
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