Abstract

One of the most important features of striated cardiac muscle is the excitability that turns on the excitation-contraction coupling cycle, resulting in the heart blood pumping function. The function of the heart pump may be impaired by events such as myocardial infarction, the consequence of coronary artery thrombosis due to blood clots or plaques. This results in the death of billions of cardiomyocytes, the formation of scar tissue, and consequently impaired contractility. A whole heart transplant remains the gold standard so far and the current pharmacological approaches tend to stop further myocardium deterioration, but this is not a long-term solution. Electrically conductive, scaffold-based cardiac tissue engineering provides a promising solution to repair the injured myocardium. The non-conductive component of the scaffold provides a biocompatible microenvironment to the cultured cells while the conductive component improves intercellular coupling as well as electrical signal propagation through the scar tissue when implanted at the infarcted site. The in vivo electrical coupling of the cells leads to a better regeneration of the infarcted myocardium, reducing arrhythmias, QRS/QT intervals, and scar size and promoting cardiac cell maturation. This review presents the emerging applications of intrinsically conductive polymers in cardiac tissue engineering to repair post-ischemic myocardial insult.

Highlights

  • Cardiovascular diseases (CVDs) represent the leading cause of death within the European Society of Cardiology member countries with 108.7 million active cases as of 2017 and 1.67 million lives lost to ischemic heart disease the same year [1]

  • Hopes that the adult human heart can regenerate after infarction remain scarce due to the low turnover rate of the cardiomyocytes

  • As the intrinsic electric field of the conductive scaffold encourages the differentiation of stem cells to cardiomyocyte-like cells, this eventually leads to the expression of the key cardiac proteins, such as Cx43, and subsequently facilitates the electrical coupling and contractility of cells

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Summary

Introduction

Cardiovascular diseases (CVDs) represent the leading cause of death within the European Society of Cardiology member countries with 108.7 million active cases as of 2017 and 1.67 million lives lost to ischemic heart disease the same year [1]. The issues related to arrhythmias and asynchronous beating of the injured myocardium are not resolved due to the non-conductive nature of most of the polymers used so far The solution to this issue has been envisioned in conveying electric signals through scaffolds with embedded polymers displaying electroconductive characteristics comparable to the biological tissues (Figure 1) and this has already been demonstrated to enhance cell differentiation to mature. In addition to this canonical role, it may act as a transcription regulator [24] This cell-laden conductive scaffold improves the electrical signal propagation through the scar tissue, when implanted in vivo, and results in repair/regeneration of the injured myocardium with elevated ventricular wall thickness, improved blood pumping ability, reduced scar size, shorter QRS/QT intervals, and lower risk of arrhythmias, as shown in Figure 2 [25]. Troconductive polymeric materials in the fabrication of functional cardiac constructs envision future directions and potential clinical applications

Polyaniline
Polypyrrole
Conductive
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