Abstract
Background: The main objective of this systematic review (PROSPERO ID 96223) is to determine the advantage in hydrogel-based treatment to achieve sustained improvement of cardiac function in heart failure (HF), compared to drug therapy or placebo in clinical and experimental models of HF. The association between different types of hydrogel and myocardial function impairment, performance status and injection-induced complications, is analysed. Methods: Literature search has been performed using computer-assisted databases (MEDLINE, EMBASE, CENTRAL and JBI database of systematic reviews and implementation reports). The search strategy and the search string (“hydrogel” AND “heart”) has been formulated following the PICO method. Outcomes aim to assess myocardial improved function as: myocardial thickness by post-mortem analysis measurement, end-diastolic volumes (left and right ventricles), 30 days mortality, post-mortem analysis of myocardial composition, dimensions and histological and immunohistochemical changes. A standardised, pre-piloted form has been used to extract data from the included studies for assessment of study quality and evidence synthesis. Risk of bias and study quality (ie. CAMARDES-checklist) have been assessed by two review authors and resolving incongruencies through discussion with a third author. Results: We provide a narrative synthesis of the findings from the included studies, structured around the type of intervention, target population characteristics, type of outcome and intervention content. Conclusions: Hydrogels injection for cardiac tissue repair seems to be a promising therapeutic approach in miocardial infarction (MI) treatment, nowadays under clinical evaluation. Hydrogels effectiveness in limiting extension and expansion of ischemic injury, resulting in improved MI survival rates, in now under investigation.
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