Elastomeric cardiopatch scaffold for myocardial repair and ventricular support

Author:

Chachques Juan Carlos1,Lila Nermine1,Soler-Botija Carolina23,Martinez-Ramos Cristina4,Valles Ana4ORCID,Autret Gwennhael5,Perier Marie-Cecile6,Mirochnik Nicolas7,Monleon-Pradas Manuel4,Bayes-Genis Antoni2,Semino Carlos E8

Affiliation:

1. Laboratory Biosurgical Research, Alain Carpentier Foundation, Cardiac Surgery Pompidou Hospital, University Paris-Descartes, Paris, France

2. Research Cardiology Institute, Germans-Trias-Pujol Hospital, Badalona, Spain

3. CIBER Cardiovascular, Carlos III Health Institute, Madrid, Spain

4. Center for Biomaterials and Tissue Engineering, Polytechnic University Valencia, Valencia, Spain

5. Microcirculation Imaging Lab, Paris Cardiovascular Research Center (PARCC), University Paris, Paris, France

6. Cardiovascular Epidemiology Unit, PARCC, University Paris, Paris, France

7. Cardiology Department, Pompidou Hospital, University Paris, Paris, France

8. Bioengineering Department, IQS-School Engineering, Ramon-Llull University, Barcelona, Spain

Abstract

Abstract OBJECTIVES Prevention of postischaemic ventricular dilatation progressing towards pathological remodelling is necessary to decrease ventricular wall deterioration. Myocardial tissue engineering may play a therapeutic role due to its capacity to replace the extracellular matrix, thereby creating niches for cell homing. In this experimental animal study, a biomimetic cardiopatch was created with elastomeric scaffolds and nanotechnologies. METHODS In an experimental animal study in 18 sheep, a cardiopatch was created with adipose tissue-derived progenitor cells seeded into an engineered bioimplant consisting of 3-dimensional bioabsorbable polycaprolactone scaffolds filled with a peptide hydrogel (PuraMatrix™). This patch was then transplanted to cover infarcted myocardium. Non-absorbable poly(ethyl) acrylate polymer scaffolds were used as controls. RESULTS Fifteen sheep were followed with ultrasound scans at 6 months, including echocardiography scans, tissue Doppler and spectral flow analysis and speckle-tracking imaging, which showed a reduction in longitudinal left ventricular deformation in the cardiopatch-treated group. Magnetic resonance imaging (late gadolinium enhancement) showed reduction of infarct size relative to left ventricular mass in the cardiopatch group versus the controls. Histopathological analysis at 6 months showed that the cardiopatch was fully anchored and integrated to the infarct area with minimal fibrosis interface, thereby promoting angiogenesis and migration of adipose tissue-derived progenitor cells to surrounding tissues. CONCLUSIONS This study shows the feasibility and effectiveness of a cardiopatch grafted onto myocardial infarction scars in an experimental animal model. This treatment decreased fibrosis, limited infarct scar expansion and reduced postischaemic ventricular deformity. A capillary network developed between our scaffold and the heart. The elastomeric cardiopatch seems to have a positive impact on ventricular remodelling and performance in patients with heart failure.

Funder

Regeneration of Cardiac Tissue Assisted by Bioactive Implants

European Commission

European Regional Development Fund

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery

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