Heart failure: Bioelectronic scaffolds to create heart tissue

Heart failure is a leading cause of morbidity worldwide. With no cure, heart transplantation remains the optimum choice for treatment. However, donor shortages severely limits this option. A potential solution is cardiac tissue engineering, which involves the creation of functional heart tissue in vitro that can be used to replace what is failing. However, unestablished methodology results in tissue that is far from representative of endogenous myocardium. This can be overcome using a flexible, three-dimensional (3D), porous micro-bioelectronic scaffold to create and monitor engineered cardiac tissue with similar functional and morphological properties to endogenous tissue. Growing cells on a bioelectronic structure results in the incorporation of electronic components within the tissue. These components can promote the correct development of cardiac tissue by electrically stimulating the cells, which can influence various properties including cell migration, orientation, maturation, and contraction. While highly sensitive biosensors present within the bioelectronics gather more reliable data by detecting various cell signalling and electrophysiology of the cardiac tissue during regeneration. By being 3D and porous, the scaffolds mimic the extracellular matrix, allowing heart cells to penetrate the structure and grow more natively, unlike more traditional two-dimensional (2D) cell culture where movement and growth are limited. These properties also allow oxygen, nutrients, and metabolic waste to diffuse more efficiently throughout the scaffold, therefore producing a more reliable cardiac tissue construct. The combination of flexible bioelectronic scaffolds with cells such as patient-specific induced pluripotent stem cell (iPSC)-derived cardiomyocytes has the potential for an endless source of reliable tissue constructs to be fabricated, in turn, promoting the creation of more personalised cardiac tissue grafts to combat heart failure.