Thromb Haemost 2015; 113(03): 532-547
DOI: 10.1160/TH14-05-0480
Theme Issue Article
Schattauer GmbH

Vascularisation for cardiac tissue engineering: the extracellular matrix

Chinmoy Patra
1   Department of Zoology, Agharkar Research Institute, Gopal Ganesh Agarkar Road, Pune, India
,
Aldo R. Boccaccini
2   Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, Erlangen, Germany
,
Felix B. Engel
3   Experimental Renal and Cardiovascular Research, Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
› Author Affiliations
Financial support: This work was supported by the ELAN Program of the Friedrich-Alexander-Universität Erlangen-Nürnberg (to F. B. E.).
Further Information

Publication History

Received: 31 May 2014

Accepted after major revision: 03 September 2014

Publication Date:
17 November 2017 (online)

Summary

Cardiovascular diseases present a major socio-economic burden. One major problem underlying most cardiovascular and congenital heart diseases is the irreversible loss of contractile heart muscle cells, the cardiomyocytes. To reverse damage incurred by myocardial infarction or by surgical correction of cardiac malformations, the loss of cardiac tissue with a thickness of a few millimetres needs to be compensated. A promising approach to this issue is cardiac tissue engineering. In this review we focus on the problem of in vitro vascularisation as implantation of cardiac patches consisting of more than three layers of cardiomyocytes (> 100 μm thick) already results in necrosis. We explain the need for vascularisation and elaborate on the importance to include non-myocytes in order to generate functional vascularised cardiac tissue. We discuss the potential of extracellular matrix molecules in promoting vascularisation and introduce nephronectin as an example of a new promising candidate. Finally, we discuss current biomaterial- based approaches including micropatterning, electrospinning, 3D micro-manufacturing technology and porogens. Collectively, the current literature supports the notion that cardiac tissue engineering is a realistic option for future treatment of paediatric and adult patients with cardiac disease.