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To overcome these limitations, we developed an albumin hydrogel platform (BST) with a closed\u2010loop pathological response system. BST is a pH\u2010responsive hydrogel, functionalized with MRI\/CT probes and loaded with mitochondria\u2010targeted CAT\u2010SOD enzyme nanogels (CSDT). It forms a self\u2010repairing scaffold with high shear viscosity (\u223c300 Pa\u00b7s), elasticity, and cardiac\u2010like mechanics (\u223c7.5 kPa), stabilizing the infarct wall. Hypoxia\u2010induced acidosis triggers the release of CSDT nanogels and albumin, enabling mitochondrial ROS scavenging and O\n                    <jats:sub>2<\/jats:sub>\n                    generation, while albumin restores tissue osmotic balance. These actions collectively alleviate oxidative stress, modulate immune responses, and promote cardiomyocyte survival by enhancing autophagy and anti\u2010apoptotic pathways. This inside\u2010out feedback mechanism reverses oxidative stress and hypoxia, shifts macrophages to a reparative M2 phenotype, and increases angiogenesis by \u223c2.5\u2010fold. In an MI mouse model, BST, with programmable biodegradation (\u223c3 weeks), restored left ventricular ejection fraction to \u223c70% of sham group and improved 28\u2010day survival by \u223c2.5\u2010fold. Furthermore, BST enables real\u2010time MRI\/CT tracking of material retention and tissue repair dynamically, permitting spatiotemporal control of the infarct microenvironment and advancing precision MI therapy toward clinical translation.\n                  <\/jats:p>","DOI":"10.1002\/advs.76312","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:40:20Z","timestamp":1782985220000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Pathology\u2010Instructed Theranostic Platform with Mechanoadaptive and ROS\u2010Powered Nanobreathing Functions for Precision Myocardial Repair"],"prefix":"10.1002","volume":"13","author":[{"given":"Zheng","family":"Luo","sequence":"first","affiliation":[{"name":"Center of Burn &amp; Plastic and Wound Healing Surgery, The First Affiliated Hospital of University of South China Hengyang Medical School, University of South China  Hengyang Hunan China"},{"name":"State Key Laboratory of Vaccines for Infectious Diseases Xiang An Biomedicine Laboratory, Fujian Provincial Key Laboratory of Innovative Drug Target Research School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences Xiamen University  Xiamen China"},{"name":"Institute of Materials Research and Engineering (IMRE) Agency for Science, Technology and Research (A*STAR)  Singapore Republic of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cui","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Medicine Xiamen University  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuzhou","family":"Mao","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Vaccines for Infectious Diseases Xiang An Biomedicine Laboratory, Fujian Provincial Key Laboratory of Innovative Drug Target Research School of Pharmaceutical Sciences, Faculty of Medicine and Life Sciences Xiamen 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