Engineered cardiac tissues for in vitro assessment of contractile function and repair mechanisms

Experimental Models of Cardiovascular Diseases: Overview

Cardiovascular disease is one of the most common causes of deaths in clinics. Experimental models of cardiovascular diseases are essential to understand disease mechanism, to provide accurate diagnoses, and to develop new therapies. Large numbers of experimental models have been proposed and replicated by many laboratories in the past. Models with significant advantages are chosen and became more popular. Particularly, feasibility, reproducibility, and human disease resemblance are the common key factors for frequently used cardiovascular disease models. In this chapter, we provide a brief overview of these experimental models used for in vitro, in vivo, and in silico studies of cardiovascular diseases.

Biomimetic cardiac microsystems for pathophysiological studies and drug screens

Microfabricated organs-on-chips consist of tissue-engineered 3D in vitro models, which rely on engineering design and provide the physiological context of human organs. Recently, significant effort has been devoted to the creation of a biomimetic cardiac system by using microfabrication techniques. By applying allometric scaling laws, microengineered cardiac systems simulating arterial flow, pulse properties, and architectural environments have been implemented, allowing high-throughput pathophysiological experiments and drug screens. In this review, we illustrate the recent trends in cardiac microsystems with emphasis on cardiac pumping and valving functions. We report problems and solutions brought to light by existing organs-on-chip models and discuss future directions of the field. We also describe the needs and desired design features that will enable the control of mechanical, electrical, and chemical environments to generate functional in vitro cardiac disease models.

Mechanically stimulated contraction of engineered cardiac constructs using a microcantilever

The beating heart undergoes cyclic mechanical and electrical activity during systole and diastole. The interaction between mechanical stimulation and propagation of the depolarization wavefront is important for understanding not just normal sinus rhythm, but also mechanically induced cardiac arrhythmia. This study presents a new platform to study mechanoelectrical coupling in a 3-D in vitro model of the myocardium. Cardiomyocytes and cardiac fibroblasts are seeded within extracellular matrix proteins and form constructs constrained by microfabricated tissue gauges that provide in situ measurement of contractile function. The microcantilever of an atomic force microscope is indented into the construct at varying magnitudes and frequencies to cause a coordinated contraction. The results indicate that changes in indentation depth and frequency do not significantly affect the magnitude of contraction, but increasing indentation frequency significantly increases the contractile velocity. Overall, this study demonstrates the validity of this platform as a means to study mechanoelectrical coupling in a 3-D setting, and to investigate the mechanism underlying mechanically stimulated contraction.

Human pluripotent stem cell-derived cardiomyocytes for heart regeneration, drug discovery and disease modeling: from the genetic, epigenetic, and tissue modeling perspectives

Heart diseases remain a major cause of mortality and morbidity worldwide. However, terminally differentiated human adult cardiomyocytes (CMs) possess a very limited innate ability to regenerate. Directed differentiation of human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) into CMs has enabled clinicians and researchers to pursue the novel therapeutic paradigm of cell-based cardiac regeneration. In addition to tissue engineering and transplantation studies, the need for functional CMs has also prompted researchers to explore molecular pathways and develop strategies to improve the quality, purity and quantity of hESC-derived and iPSC-derived CMs. In this review, we describe various approaches in directed CM differentiation and driven maturation, and discuss potential limitations associated with hESCs and iPSCs, with an emphasis on the role of epigenetic regulation and chromatin remodeling, in the context of the potential and challenges of using hESC-CMs and iPSC-CMs for drug discovery and toxicity screening, disease modeling, and clinical applications.

Myocyte-depleted engineered cardiac tissues support therapeutic potential of mesenchymal stem cells

The therapeutic potential of mesenchymal stem cells (MSCs) for restoring cardiac function after cardiomyocyte loss remains controversial. Engineered cardiac tissues (ECTs) offer a simplified three-dimensional in vitro model system to evaluate stem cell therapies. We hypothesized that contractile properties of dysfunctional ECTs would be enhanced by MSC treatment. ECTs were created from neonatal rat cardiomyocytes with and without bone marrow-derived adult rat MSCs in a type-I collagen and Matrigel scaffold using custom elastomer molds with integrated cantilever force sensors. Three experimental groups included the following: (1) baseline condition ECT consisting only of myocytes, (2) 50% myocyte-depleted ECT, modeling a dysfunctional state, and (3) 50% myocyte-depleted ECT plus 10% MSC, modeling dysfunctional myocardium with intervention. Developed stress (DS) and pacing threshold voltage (VT) were measured using 2-Hz field stimulation at 37°C on culture days 5, 10, 15, and 20. By day 5, DS of myocyte-depleted ECTs was significantly lower than baseline, and VT was elevated. In MSC-supplemented ECTs, DS and VT were significantly better than myocyte-depleted values, approaching baseline ECTs. Findings were similar through culture day 15, but lost significance at day 20. Trends in DS were partly explained by changes in the cell number and alignment with time. Thus, supplementing myocyte-depleted ECTs with MSCs transiently improved contractile function and compensated for a 50% loss of cardiomyocytes, mimicking recent animal studies and clinical trials and supporting the potential of MSCs for myocardial therapy.

Cardiac tissue engineering using human stem cell-derived cardiomyocytes for disease modeling and drug discovery

Cardiovascular disease (CVD) is the most prevalent health problem in the world, and the high mortality rate associated with irreversibly injured heart muscle motivates an urgent need for the development of novel therapies to treat damaged myocardium. Recently, human engineered cardiac tissues (hECT) have been created using cardiomyocytes derived from human embryonic stem cells and human induced pluripotent stem cells. Although a healthy adult phenotype remains elusive, such hECT display structural and functional properties that recapitulate key aspects of natural human myocardium, including dose related responses to compounds with known chronotropic, inotropic and arrhythmogenic effects. Thus, hECT offer the advantage over traditional in vitro culture models of providing a biomimetic 3D environment for the study of myocardial physiopathology, and may be used to generate preclinical models for the development and screening of therapies for CVD.

Human pluripotent stem cell-based approaches for myocardial repair: from the electrophysiological perspective

Heart diseases are a leading cause of mortality worldwide. Terminally differentiated adult cardiomyocytes (CMs) lack the innate ability to regenerate. Their malfunction or significant loss can lead to conditions from cardiac arrhythmias to heart failure. For myocardial repair, cell- and gene-based therapies offer promising alternatives to donor organ transplantation. Human embryonic stem cells (hESCs) can self-renew while maintaining their pluripotency. Direct reprogramming of adult somatic cells to become pluripotent hES-like cells (also known as induced pluripotent stem cells or iPSCs) has been achieved. Both hESCs and iPSCs have been successfully differentiated into genuine human CMs. In this review, we describe our current knowledge of the structure-function properties of hESC/iPSC-CMs, with an emphasis on their electrophysiology and Ca(2+) handling, along with the hurdles faced and potential solutions for translating into clinical and other applications (e.g., disease modeling, cardiotoxicity and drug screening).

Neonatal mouse-derived engineered cardiac tissue: a novel model system for studying genetic heart disease

RATIONALE

Cardiomyocytes cultured in a mechanically active 3-dimensional configuration can be used for studies that correlate contractile performance to cellular physiology. Current engineered cardiac tissue (ECT) models use cells derived from either rat or chick hearts. Development of a murine ECT would provide access to many existing models of cardiac disease and open the possibility of performing targeted genetic manipulation with the ability to directly assess contractile and molecular variables.

OBJECTIVE

To generate, characterize, and validate mouse ECT with a physiologically relevant model of hypertrophic cardiomyopathy.

METHODS AND RESULTS

We generated mechanically integrated ECT using isolated neonatal mouse cardiac cells derived from both wild-type and myosin-binding protein C (cMyBP-C)-null mouse hearts. The murine ECTs produced consistent contractile forces that followed the Frank-Starling law and accepted physiological pacing. cMyBP-C-null ECTs showed characteristic acceleration of contraction kinetics. Adenovirus-mediated expression of human cMyBP-C in murine cMyBP-C-null ECT restored contractile properties to levels indistinguishable from those of wild-type ECT. Importantly, the cardiomyocytes used to construct the cMyBP-C(-/-) ECT had yet to undergo the significant hypertrophic remodeling that occurs in vivo. Thus, this murine ECT model reveals a contractile phenotype that is specific to the genetic mutation rather than to secondary remodeling events.

CONCLUSIONS

Data presented here show mouse ECT to be an efficient and cost-effective platform to study the primary effects of genetic manipulation on cardiac contractile function. This model provides a previously unavailable tool to study specific sarcomeric protein mutations in an intact mammalian muscle system.

Construction of cardiac tissue rings using a magnetic tissue fabrication technique

Here we applied a magnetic force-based tissue engineering technique to cardiac tissue fabrication. A mixture of extracellular matrix precursor and cardiomyocytes labeled with magnetic nanoparticles was added into a well containing a central polycarbonate cylinder. With the use of a magnet, the cells were attracted to the bottom of the well and allowed to form a cell layer. During cultivation, the cell layer shrank towards the cylinder, leading to the formation of a ring-shaped tissue that possessed a multilayered cell structure and contractile properties. These results indicate that magnetic tissue fabrication is a promising approach for cardiac tissue engineering.