Table 1.
Type | Matrix source | Cell source | Modification | Improvements after transplantation | Advantage | Shortage | Clinical trial |
---|---|---|---|---|---|---|---|
Decellularized | Cadaveric and animal source: Myocardial ECM, pericardium ECM, SIS, UBM, and so on |
Alone, MSC, ATDSC, NRVCM, cardiomyocytes, and so on | FGF, HGF | LVEF ↑, LVFS ↑, infarct LV wall thickness ↑, infarct zone ↓, LV end diastolic and systolic pressure improvements | Purely extracellular matrix Exact multiscale structure Excellent biocompatibility Less rejection responses Preserved vascular network |
Immature cells within a mature matrix Nonuniform decellularization protocols Lack of standards for successful decellularization Variable sample composition Limited by its own architecture |
CorMatrix ECM trial [16] |
| |||||||
Fibro matrix | Natural fibers: Collagen, fibrin, chitosan, alginate, hyaluronic acid, gelatin, albumin, and so on Artificial synthetic fibers: PGA, PLGA, PCU, PGS, PLA, PCL, PEG, and so on |
Natural fibers always mixed with differentiated and proliferative potential cells: iPSC, MSC, ESC, BMMNC, and so on or simply alone. Artificial synthetic fibers usually are seeded with cardiac/smooth muscle cells: NRVCM, H9C2 cell line, C2C12 cell line, and so on |
VEGF, FGF, HGF, IGF, TGFb, SDF-1a, physical stimulation, etc. “bio-hybrid” |
Cell survival and retention ↑, LVEF ↑, LVFS ↑, contractile synchronicity ↑, LV end-diastolic pressure ↓, LV pressure change ↑, infarct size ↓, fibrosis ↓ | Diversity of materials and solvents Control of fiber morphology (nano to macro) Nano-micro scale fiber fabrication Prefect force strength Well conduction velocity |
Requires conductive polymers and solvents Low production rates Reproducible fiber production requires environmental control Less biocompatibility Lack of native stimulations for cell proliferation Considerate biodegradable behavior |
MAGNUM [17] ESCORT [NCT02057900] |
| |||||||
Hydrogel tissue model | Matrigel, Collagen, and so on | Alone, ESC, NRVCM, myoblasts, cardiomyocytes, and so on | VEGF, FGF | LVFS ↑, infarct size ↓, infarcted/noninfarcted wall thickness ratio ↑, LV wall thickness preservation Usually no LVEF improvements without components |
Scaffold free Minimally invasive Catheter-based approach available |
Limited to build macropieces Persist heart pressure but not improve contractile function among all researches |
PRESERVATION [18] AUGMENT-HF [19] |
ATDSC: adipose tissue derived stem cell; BMMNC: bone marrow mononuclear cell; ECM: extracellular matrix; ESC: embryonic stem cell; FGF: fibroblast growth factor; HGF: hepatocyte growth factor; IGF: insulin-like growth factor; iPSC: induced pluripotent stem cell; LVEF: left ventricular ejection fraction; LVFS: left ventricular fractional shortening; MSC: mesenchymal stem cell; NRVCM: neonatal rat ventricular cardiomyocyte; PCL: poly(ε-caprolactone); PCU: polycarbonate-urethane; PEG: polyethylene glycol; PGA: poly(glycolic acid); PGS: poly(glycerol sebacate); PLA: polylactic acid; PLGA: poly(lactic-co-glycolic) acid; SDF-1: stromal cell derived factor-1; SIS: small intestine submucosa; TGF: transforming growth factor; UBM: urinary bladder matrix; VEGF: vascular endothelial growth factor.