![]() In this review, both the therapeutic ingredients and biomaterials will be discussed ( Table 1), but topics such as disease modeling ( 58), bioreactor stimulation ( 59), microphysiologic systems ( 60) will not be included. Some patches are generated from in vivo sources like collagen ( 34), fibrin ( 35), decellularized ECM ( 36) and even cell sheets ( 37), providing outstanding biocompatibility compared to synthesized materials ( 38). Polymers are the most used materials for cardiac patch fabrication ( 32, 33). Whether natural or synthesized, these scaffolding materials offer a suitable environment for therapeutic ingredients ( 29– 31). A large number of biomaterials used to fabricate cardiac patches have emerged during the last decade ( 25– 28). The therapeutic ingredients for cardiac patches range from cells (such as skeletal myoblasts, mesenchymal stem cells and human pluripotent stem cells) to bioactive molecules (including growth factors, microRNA and extracellular vesicles) ( 22– 24). With the development of fabrication technologies, more and more cardiac patches with excellent therapeutic performance have been developed ( 21) ( Figure 1). ![]() The component of a cardiac patch can be simply divided into two parts: substrate and therapeutic ingredients ( 20). In virtue of the engineered biomaterials, cardiac patches show promising potential in promoting cardiac function ( 18, 19). Hence, delivery methods are highly demanded to achieve better therapeutic performance. However, these therapeutics always suffer from low stability and short half-lifetime. Preclinical studies have demonstrated the therapeutic performance of several approaches to treat MI, such as the injection of stem cells ( 13, 14), genes ( 15, 16) and growth factors ( 17). Thus, it is still a challenge to explore novel therapeutic methods for myocardium regeneration. ![]() The loss of the contractile capacity leads to the dysfunction of heart and causes heart failure eventually ( 11, 12). Suffered from such an irreversible cardiac muscle death, CMs will be gradually replaced by fibrotic scar tissues ( 8– 10). Due to the lack of regeneration ability, cardiomyocytes (CMs) in adult mammalian heart can hardly recover from ischemic injuries, like myocardial infarction (MI) ( 4– 7). Heart disease remains a leading problem threatening millions of people worldwide ( 1– 3). Also, we have focused on the challenges and potential strategies to fabricate clinically applicable cardiac patches. In the meanwhile, the recent advances to obtain scaffold biomaterials will be highlighted, including synthetic and natural materials. The therapeutic ingredients will be discussed from cell sources to bioactive molecules. In this review, we will present the most state-of-the-art cardiac patches and analysis their compositional details. ![]() Consisted of two components: therapeutic ingredients and substrate scaffolds, the fabrication of cardiac patches requires both advanced bioactive molecules and biomaterials. As one of the most outstanding technology, cardiac patches hold the potential to restore cardiac function clinically. The development of tissue engineering has launched a new medical innovation for heart regeneration. In the adult mammalian heart, damaged cardiomyocytes will be replaced by non-contractile fibrotic scar tissues due to the poor regenerative ability of heart, causing heart failure subsequently. 2Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, NC, United Statesįor the past decades, heart diseases remain the leading cause of death worldwide.1Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States.
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