{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:25:58Z","timestamp":1786969558005,"version":"build-2736575974"},"reference-count":111,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T00:00:00Z","timestamp":1786752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomimetics"],"abstract":"<jats:p>Myocardial infarction remains a leading cause of heart failure because current reperfusion therapies cannot prevent adverse ventricular remodeling or restore lost cardiomyocytes. Regenerative strategies based on stem cells and extracellular vesicles (EVs) have emerged as promising approaches; however, their clinical efficacy is limited by poor retention, rapid clearance, and the hostile post-infarction microenvironment. This narrative review critically examines the role of biomaterial-assisted delivery systems in enhancing stem cell and EV-based cardiac regeneration, with particular emphasis on the distinction between biomimetic and bioactive biomaterials, mechanisms of action, preclinical and clinical evidence, translational barriers, and emerging regenerative technologies. Current evidence demonstrates that injectable hydrogels, extracellular matrix-derived scaffolds, cardiac patches, conductive biomaterials, and multifunctional delivery platforms improve therapeutic retention, prolong paracrine signaling, and actively modulate inflammation, angiogenesis, fibrosis, and extracellular matrix remodeling, resulting in superior functional recovery compared with conventional delivery approaches in preclinical models. Nevertheless, robust clinical evidence remains limited because few biomaterial-assisted strategies have advanced beyond early-phase studies. Future progress will depend on integrating smart biomaterials with engineered extracellular vesicles, gene editing, and personalized regenerative approaches, together with standardized manufacturing, harmonized regulatory frameworks, and adequately powered clinical trials.<\/jats:p>","DOI":"10.3390\/biomimetics11080583","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:00:05Z","timestamp":1786964405000},"page":"583","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomaterial-Assisted Stem Cell Therapy and Exosome Delivery in Myocardial Infarction: A Narrative Review"],"prefix":"10.3390","volume":"11","author":[{"given":"Amanda-Ioana","family":"R\u0103du\u0163\u0103","sequence":"first","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9232-8063","authenticated-orcid":false,"given":"Andreea-Ramona","family":"Treteanu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center of Innovation and e-Health, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9053-0018","authenticated-orcid":false,"given":"Octavian","family":"Andronic","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center of Innovation and e-Health, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4678-9655","authenticated-orcid":false,"given":"\u0218tefan","family":"Busnatu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Center of Innovation and e-Health, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 030167 Bucharest, Romania"},{"name":"Department of Cardiology, Emergency Hospital Bagdasar-Arseni, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Nicoleta","family":"Sili\u015fte","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Col\u0163ea Clinical Hospital, 030171 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1380-1424","authenticated-orcid":false,"given":"Elena","family":"B\u0103l\u0103\u0219escu","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/CM9.0000000000004006","article-title":"Global burden of ischemic heart disease from 1990 to 2021: Findings from the Global Burden of Disease Study 2021 and predictions to 2030","volume":"139","author":"Jing","year":"2026","journal-title":"Chin. Med. J."},{"key":"ref_2","first-page":"e102070","article-title":"Global trends in mortality from ischemic heart disease and the expansion of interventional cardiology procedures: An analysis using the Global Burden of Disease dataset","volume":"18","author":"Okorigba","year":"2026","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Leanc\u0103, S.A., Cri\u0219u, D., Petri\u0219, A.O., Afr\u0103s\u00e2nie, I., Genes, A., Costache, A.D., Tesloianu, D.N., and Costache, I.I. (2022). Left ventricular remodeling after myocardial infarction: From physiopathology to treatment. Life, 12.","DOI":"10.3390\/life12081111"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"41982","DOI":"10.1038\/s41598-025-26248-x","article-title":"Global, regional, and national burden of ischemic heart disease in young and middle-aged population from 1990 to 2021","volume":"15","author":"Song","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_5","first-page":"e45578","article-title":"Advancements in myocardial infarction management: Exploring novel approaches and strategies","volume":"15","author":"Sachdeva","year":"2023","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/j.jacc.2024.02.056","article-title":"Reperfusion injury in patients with acute myocardial infarction: JACC Scientific Statement","volume":"83","author":"Welt","year":"2024","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Arnautu, D.A., Andor, M., Buz, B.F., Tomescu, M.C., Vacarescu, C., Crisan, S., Gaita, D., Luca, C.T., and Cozma, D. (2022). Left ventricular remodeling and heart failure predictors in acute myocardial infarction patients with preserved left ventricular ejection fraction after successful percutaneous intervention in Western Romania. Life, 12.","DOI":"10.3390\/life12101636"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mitsis, A., Kyriakou, M., Sokratous, S., Karmioti, G., Drakomathioulakis, M., Myrianthefs, M., Ziakas, A., Tzikas, S., and Kassimis, G. (2024). Exploring the landscape of anti-inflammatory trials: A comprehensive review of strategies for targeting inflammation in acute myocardial infarction. Biomedicines, 12.","DOI":"10.20944\/preprints202402.1548.v1"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Le, N.T., Dunleavy, M.W., Zhou, W., Bhatia, S.S., Kumar, R.D., Woo, S.T., Ramirez-Pulido, G., Ramakrishnan, K.S., and El-Hashash, A.H. (2025). Stem cell therapy for myocardial infarction recovery: Advances, challenges, and future directions. Biomedicines, 13.","DOI":"10.20944\/preprints202504.0288.v1"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Azimian Zavareh, V., Eslampoor, N., Panahi-Alanagh, S., Malekmohammad, L., and Stanek, A. (2026). Mesenchymal stem cell-derived exosomes in myocardial infarction repair: Therapeutic potential and scaffold-based delivery strategies. Front. Pharmacol., 17.","DOI":"10.3389\/fphar.2026.1762630"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3271","DOI":"10.1021\/acsbiomaterials.2c00454","article-title":"Role of biomaterials in cardiac repair and regeneration: Therapeutic intervention for myocardial infarction","volume":"8","author":"Tariq","year":"2022","journal-title":"ACS Biomater. Sci. Eng."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e70174","DOI":"10.1002\/biot.70174","article-title":"Advanced scaffold-guided stem cell therapies for myocardial regeneration: Integrating biomaterials, cell engineering, and smart delivery systems","volume":"21","author":"Yousefi","year":"2026","journal-title":"Biotechnol. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"II-38\u2013II-44","DOI":"10.1002\/j.1932-8737.1997.tb00011.x","article-title":"Plaque disruption and coronary thrombosis: New insight into pathogenesis and prevention","volume":"20","author":"Shah","year":"1997","journal-title":"Clin. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1093\/eurheartj\/ehs411","article-title":"Update on acute coronary syndromes: The pathologists\u2019 view","volume":"34","author":"Falk","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1161\/CIRCRESAHA.114.302721","article-title":"Mechanisms of plaque formation and rupture","volume":"114","author":"Bentzon","year":"2014","journal-title":"Circ. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ciortan, L., Macarie, R.D., Barbu, E., Naie, M.L., Mihaila, A.C., Serbanescu, M., and Butoi, E. (2025). Cross-talk between neutrophils and macrophages post-myocardial infarction: From inflammatory drivers to therapeutic targets. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms262110575"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Juricic, S., Klac, J., Stojkovic, S., Beleslin, B., Tesic, M., Jovanovic, I., Banovic, M., Petrovic, O., Aleksandric, S., and Vasic, N. (2026). Molecular and cellular mechanisms of myocardial ischemia and reperfusion injury: A narrative review. Cells, 15.","DOI":"10.3390\/cells15030265"},{"key":"ref_18","first-page":"1113","article-title":"Myofibroblasts and the extracellular matrix network in post-myocardial infarction cardiac remodeling","volume":"466","author":"Ma","year":"2014","journal-title":"Pflug. Arch."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tsurusaki, S., and Kizana, E. (2024). Mechanisms and therapeutic potential of multiple forms of cell death in myocardial ischemia-reperfusion injury. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252413492"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1161\/CIRCRESAHA.124.323658","article-title":"Repair of the infarcted heart: Cellular effectors, molecular mechanisms and therapeutic opportunities","volume":"134","author":"Hilgendorf","year":"2024","journal-title":"Circ. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1161\/CIRCRESAHA.116.303577","article-title":"The biological basis for cardiac repair after myocardial infarction: From inflammation to fibrosis","volume":"119","author":"Prabhu","year":"2016","journal-title":"Circ. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1161\/CIRCRESAHA.119.311148","article-title":"The extracellular matrix in ischemic and nonischemic heart failure","volume":"125","author":"Frangogiannis","year":"2019","journal-title":"Circ. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"223","DOI":"10.2174\/1573403X13666170502103833","article-title":"Adult stem cell therapy for cardiac repair in patients after acute myocardial infarction leading to ischemic heart failure: An overview of evidence from recent clinical trials","volume":"13","author":"Katarzyna","year":"2017","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.yjmcc.2010.06.010","article-title":"Cardiac cell therapy: Lessons from clinical trials","volume":"50","author":"Menasche","year":"2011","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/CIRCRESAHA.113.301202","article-title":"Bone-derived stem cells repair the heart after myocardial infarction through transdifferentiation and paracrine signaling mechanisms","volume":"113","author":"Duran","year":"2013","journal-title":"Circ. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s13287-025-04882-6","article-title":"Stem cell therapy for patients with acute myocardial infarction: A systematic review of clinical trials","volume":"17","author":"Mahram","year":"2025","journal-title":"Stem Cell Res. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/S0140-6736(04)16626-9","article-title":"Intracoronary autologous bone-marrow cell transfer after myocardial infarction: The BOOST randomised controlled clinical trial","volume":"364","author":"Wollert","year":"2004","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2978","DOI":"10.1093\/eurheartj\/ehp374","article-title":"Intracoronary bone marrow cell transfer after myocardial infarction: 5-year follow-up from the randomized-controlled BOOST trial","volume":"30","author":"Meyer","year":"2009","journal-title":"Eur. Heart J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2936","DOI":"10.1093\/eurheartj\/ehx188","article-title":"Intracoronary autologous bone marrow cell transfer after myocardial infarction: The BOOST-2 randomised placebo-controlled clinical trial","volume":"38","author":"Wollert","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1634\/stemcells.2008-0273","article-title":"IFATS collection: Human adipose tissue-derived stem cells induce angiogenesis and nerve sprouting following myocardial infarction, in conjunction with potent preservation of cardiac function","volume":"27","author":"Cai","year":"2009","journal-title":"Stem Cells"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1016\/j.jacc.2010.03.066","article-title":"Guided cardiopoiesis enhances therapeutic benefit of bone marrow human mesenchymal stem cells in chronic myocardial infarction","volume":"56","author":"Behfar","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/term.3262","article-title":"Amniotic stromal stem cell-loaded hydrogel repairs cardiac tissue in infarcted rat hearts via paracrine mediators","volume":"16","author":"Khan","year":"2022","journal-title":"J. Tissue Eng. Regen. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"15007","DOI":"10.1038\/cddiscovery.2015.7","article-title":"Rap1-mediated nuclear factor-kappa B activity regulates the paracrine capacity of mesenchymal stem cells in heart repair following infarction","volume":"1","author":"Zhang","year":"2015","journal-title":"Cell Death Discov."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/cvr\/cvr053","article-title":"VEGF\/SDF-1 promotes cardiac stem cell mobilization and myocardial repair in the infarcted heart","volume":"91","author":"Tang","year":"2011","journal-title":"Cardiovasc. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s10238-021-00682-3","article-title":"Stem cell therapy in acute myocardial infarction: A new era?","volume":"21","author":"Carbone","year":"2021","journal-title":"Clin. Exp. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.yjmcc.2018.04.012","article-title":"Exosomal miR-21a-5p mediates cardioprotection by mesenchymal stem cells","volume":"119","author":"Luther","year":"2018","journal-title":"J. Mol. Cell. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1093\/cvr\/cvu167","article-title":"Extracellular vesicles from human cardiac progenitor cells inhibit cardiomyocyte apoptosis and improve cardiac function after myocardial infarction","volume":"103","author":"Barile","year":"2014","journal-title":"Cardiovasc. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"6163","DOI":"10.7150\/thno.28021","article-title":"Hypoxia-elicited mesenchymal stem cell-derived exosomes facilitate cardiac repair through miR-125b-mediated prevention of cell death in myocardial infarction","volume":"8","author":"Zhu","year":"2018","journal-title":"Theranostics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13062-024-00485-y","article-title":"M2 macrophage-derived exosomes promote angiogenesis and improve cardiac function after myocardial infarction","volume":"19","author":"Guo","year":"2024","journal-title":"Biol. Direct"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1161\/CIRCRESAHA.117.311326","article-title":"Intra-cardiac release of extracellular vesicles shapes inflammation following myocardial infarction","volume":"123","author":"Loyer","year":"2018","journal-title":"Circ. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"24275","DOI":"10.1038\/s41598-024-75517-8","article-title":"Potential cardiac-derived exosomal miRNAs involved in cardiac healing and remodeling after myocardial ischemia\u2013reperfusion injury","volume":"14","author":"Liu","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.2147\/IJN.S441307","article-title":"Nicorandil-pretreated mesenchymal stem cell-derived exosomes facilitate cardiac repair after myocardial infarction via promoting macrophage M2 polarization by targeting the miR-125a-5p\/TRAF6\/IRF5 signaling pathway","volume":"19","author":"Gong","year":"2024","journal-title":"Int. J. Nanomed."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.7150\/thno.20524","article-title":"Targeting regenerative exosomes to myocardial infarction using cardiac homing peptide","volume":"8","author":"Vandergriff","year":"2018","journal-title":"Theranostics"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1042\/CS20220216","article-title":"Multicellular regulation of miR-196a-5p and miR-425-5p from adipose stem cell-derived exosomes and cardiac repair","volume":"136","author":"Neri","year":"2022","journal-title":"Clin. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1038\/s41419-020-2545-6","article-title":"Exosomal miR-25-3p from mesenchymal stem cells alleviates myocardial infarction by targeting pro-apoptotic proteins and EZH2","volume":"11","author":"Peng","year":"2020","journal-title":"Cell Death Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1161\/CIRCULATIONAHA.123.065005","article-title":"Inhalable stem cell exosomes promote heart repair after myocardial infarction","volume":"150","author":"Li","year":"2024","journal-title":"Circulation"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1093\/cvr\/cvz040","article-title":"Mesenchymal stromal cell-derived exosomes attenuate myocardial ischaemia\u2013reperfusion injury through miR-182-regulated macrophage polarization","volume":"115","author":"Zhao","year":"2019","journal-title":"Cardiovasc. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1186\/s12951-024-02631-0","article-title":"Targeted delivery of miR-146a via IMTP-modified milk exosomes exerts cardioprotective effects by inhibiting the NF-\u03baB signaling pathway after myocardial ischemia\u2013reperfusion injury","volume":"22","author":"Meng","year":"2024","journal-title":"J. Nanobiotechnol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1007\/s10753-021-01460-9","article-title":"Adipose-derived mesenchymal stem cell-derived exosomes carry microRNA-671 to alleviate myocardial infarction through inactivation of the TGFBR2\/Smad2 axis","volume":"44","author":"Wang","year":"2021","journal-title":"Inflammation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1038\/s41420-022-00909-6","article-title":"Mesenchymal stem cell-derived exosomal microRNA-182-5p alleviates myocardial ischemia\/reperfusion injury by targeting GSDMD in mice","volume":"8","author":"Yue","year":"2022","journal-title":"Cell Death Discov."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1186\/s13287-023-03462-w","article-title":"Exosomes secreted by endothelial cells derived from human induced pluripotent stem cells improve recovery from myocardial infarction in mice","volume":"14","author":"Li","year":"2023","journal-title":"Stem Cell Res. Ther."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1172\/JCI123135","article-title":"MicroRNA-21-5p dysregulation in exosomes derived from heart failure patients impairs regenerative potential","volume":"129","author":"Qiao","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Belviso, I., Romano, V., Sacco, A.M., Ricci, G., Massai, D., Cammarota, M., Catizone, A., Schiraldi, C., Nurzynska, D., and Terzini, M. (2020). Decellularized human dermal matrix as a biological scaffold for cardiac repair and regeneration. Front. Bioeng. Biotechnol., 8.","DOI":"10.3389\/fbioe.2020.00229"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1161\/CIRCRESAHA.115.306874","article-title":"Bioengineering human myocardium on native extracellular matrix","volume":"118","author":"Guyette","year":"2016","journal-title":"Circ. Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Kerignard, E., Bethry, A., Falcoz, C., Nottelet, B., and Pinese, C. (2022). Design of hybrid polymer nanofiber\/collagen patches releasing IGF and HGF to promote cardiac regeneration. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14091854"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e2305967","DOI":"10.1002\/advs.202305967","article-title":"Biodegradable cardiac occluder with surface modification by gelatin\u2013peptide conjugate to promote endogenous tissue regeneration","volume":"11","author":"Kong","year":"2024","journal-title":"Adv. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Basara, G., Ozcebe, S.G., Ellis, B.W., and Zorlutuna, P. (2021). Tunable human myocardium-derived decellularized extracellular matrix for 3D bioprinting and cardiac tissue engineering. Gels, 7.","DOI":"10.1101\/2021.03.30.437600"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"120033","DOI":"10.1016\/j.biomaterials.2020.120033","article-title":"Engineered human myocardium with local release of angiogenic proteins improves vascularization and cardiac function in injured rat hearts","volume":"251","author":"Munarin","year":"2020","journal-title":"Biomaterials"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Wang, X., Pierre, V., Senapati, S., Park, P.S., and Senyo, S.E. (2021). Microenvironment stiffness amplifies post-ischemia heart regeneration in response to exogenous extracellular matrix proteins in neonatal mice. Front. Cardiovasc. Med., 8.","DOI":"10.3389\/fcvm.2021.773978"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.actbio.2020.06.032","article-title":"Microenvironment stiffness requires decellularized cardiac extracellular matrix to promote heart regeneration in the neonatal mouse heart","volume":"113","author":"Wang","year":"2020","journal-title":"Acta Biomater."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"12525","DOI":"10.1021\/acsnano.9b03050","article-title":"Nanoparticle-based hybrid scaffolds for deciphering the role of multimodal cues in cardiac tissue engineering","volume":"13","author":"Lee","year":"2019","journal-title":"ACS Nano"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1038\/s44161-024-00428-w","article-title":"YAP induces a neonatal-like pro-renewal niche in the adult heart","volume":"3","author":"Li","year":"2024","journal-title":"Nat. Cardiovasc. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"633","DOI":"10.4252\/wjsc.v14.i8.633","article-title":"Combination of mesenchymal stem cells and three-dimensional collagen scaffold preserves ventricular remodeling in a rat myocardial infarction model","volume":"14","author":"Qazi","year":"2022","journal-title":"World J. Stem Cells"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.actbio.2021.03.017","article-title":"Delivery of cardiovascular progenitors with biomimetic microcarriers reduces adverse ventricular remodeling in a rat model of chronic myocardial infarction","volume":"126","author":"Garbayo","year":"2021","journal-title":"Acta Biomater."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Mancuso, A., Cianflone, E., Cristiano, M.C., Salerno, N., Tarsitano, M., Marino, F., Molinaro, C., Fresta, M., Torella, D., and Paolino, D. (2022). Lyotropic liquid crystals: A biocompatible and safe material for local cardiac application. Pharmaceutics, 14.","DOI":"10.3390\/pharmaceutics14020452"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e2410590","DOI":"10.1002\/advs.202410590","article-title":"Injectable pH-responsive conductive hydrogel for intelligent delivery of metformin and exosomes to enhance cardiac repair after myocardial ischemia-reperfusion injury","volume":"12","author":"Cheng","year":"2025","journal-title":"Adv. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"10216","DOI":"10.1021\/acsnano.4c00509","article-title":"Injectable and conductive nanomicelle hydrogel with \u03b1-tocopherol encapsulation for enhanced myocardial infarction repair","volume":"18","author":"Zhang","year":"2024","journal-title":"ACS Nano"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Hong, S.B., Jeong, J.O., and Choi, H. (2025). Hydrogels in cardiac surgery: Versatile platforms for tissue repair, adhesion prevention, and localized therapeutics. Gels, 11.","DOI":"10.3390\/gels11070564"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Lan, Y., Xu, Z., Li, Y., Liu, D., Lu, W., Li, Z., Chen, P., and Chen, G. (2026). A bioactive heart-derived ECM hydrogel potentiates astragaloside IV-mediated microvascular regeneration. Front. Bioeng. Biotechnol., 14.","DOI":"10.3389\/fbioe.2026.1800990"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e2307353","DOI":"10.1002\/advs.202307353","article-title":"Paintable decellularized-ECM hydrogel for preventing cardiac tissue damage","volume":"11","author":"Lee","year":"2024","journal-title":"Adv. Sci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e2401561","DOI":"10.1002\/smll.202401561","article-title":"Multimaterial printing of serpentine microarchitectures with synergistic mechanical\/piezoelectric stimulation for enhanced cardiac-specific functional regeneration","volume":"20","author":"Han","year":"2024","journal-title":"Small"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.biomaterials.2019.03.015","article-title":"Engineering a naturally derived adhesive and conductive cardiopatch","volume":"207","author":"Walker","year":"2019","journal-title":"Biomaterials"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e2304207","DOI":"10.1002\/adhm.202304207","article-title":"A novel conductive polypyrrole-chitosan hydrogel containing human endometrial mesenchymal stem cell-derived exosomes facilitates sustained release for cardiac repair","volume":"13","author":"Yan","year":"2024","journal-title":"Adv. Healthc. Mater."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"100155","DOI":"10.1016\/j.nwnano.2025.100155","article-title":"Nanotechnology-driven cardiac tissue engineering and 3D bioprinting: Mechanistic insights into myocardial repair and regeneration","volume":"12","author":"Samal","year":"2025","journal-title":"Nano Trends"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Guo, J., Yang, Z., Wang, X., Xu, Y., Lu, Y., Qin, Z., Zhang, L., Xu, J., Wang, W., and Zhang, J. (2021). Advances in nanomaterials for injured heart repair. Front. Bioeng. Biotechnol., 9.","DOI":"10.3389\/fbioe.2021.686684"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"20246","DOI":"10.1021\/acsnano.3c06229","article-title":"Ammonium persulfate-loaded carboxylic gelatin-methacrylate nanoparticles promote cardiac repair by activating epicardial epithelial\u2013mesenchymal transition via autophagy and the mTOR pathway","volume":"17","author":"Song","year":"2023","journal-title":"ACS Nano"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.stem.2017.11.010","article-title":"Direct in vivo reprogramming with Sendai virus vectors improves cardiac function after myocardial infarction","volume":"22","author":"Miyamoto","year":"2018","journal-title":"Cell Stem Cell"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1161\/CIRCULATIONAHA.121.058655","article-title":"Direct reprogramming improves cardiac function and reverses fibrosis in chronic myocardial infarction","volume":"147","author":"Tani","year":"2023","journal-title":"Circulation"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1161\/CIRCULATIONAHA.124.072733","article-title":"Cellular reprogramming by PHF7 enhances cardiac function following myocardial infarction","volume":"152","author":"Bann","year":"2025","journal-title":"Circulation"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"3185","DOI":"10.1007\/s11010-024-05184-w","article-title":"Enhancing cardiac regeneration: Direct reprogramming of fibroblasts into myocardial-like cells using extracellular vesicles secreted by cardiomyocytes","volume":"480","author":"Yao","year":"2025","journal-title":"Mol. Cell. Biochem."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ymthe.2021.10.015","article-title":"CRISPR activation of endogenous genes reprograms fibroblasts into cardiovascular progenitor cells for myocardial infarction therapy","volume":"30","author":"Jiang","year":"2022","journal-title":"Mol. Ther."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"4481","DOI":"10.1038\/s41598-023-31286-4","article-title":"CRISPR-Cas9 editing of TLR4 to improve the outcome of cardiac cell therapy","volume":"13","author":"Schary","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/j.jconrel.2024.05.023","article-title":"Small extracellular vesicle-mediated CRISPR-Cas9 RNP delivery for cardiac-specific genome editing","volume":"370","author":"Mun","year":"2024","journal-title":"J. Control. Release"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.apsb.2019.09.003","article-title":"Lineage reprogramming of fibroblasts into induced cardiac progenitor cells by CRISPR\/Cas9-based transcriptional activators","volume":"10","author":"Wang","year":"2020","journal-title":"Acta Pharm. Sin. B"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"102390","DOI":"10.1016\/j.omtn.2024.102390","article-title":"Direct cardiac reprogramming via combined CRISPRa-mediated endogenous Gata4 activation and exogenous Mef2c and Tbx5 expression","volume":"35","author":"Huang","year":"2024","journal-title":"Mol. Ther. Nucleic Acids"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.1016\/j.ymthe.2026.02.027","article-title":"CRISPR-Cas-based activation of PPARGC1A boosts endogenous mitochondria and enhances cardiac function after myocardial infarction","volume":"34","author":"Escobar","year":"2026","journal-title":"Mol. Ther."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/CIRCRESAHA.118.314522","article-title":"CRISPR-mediated activation of endogenous gene expression in the postnatal heart","volume":"126","author":"Schoger","year":"2020","journal-title":"Circ. Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e008737","DOI":"10.1161\/JAHA.118.008737","article-title":"Engineered exosomes with ischemic myocardium-targeting peptide for targeted therapy in myocardial infarction","volume":"7","author":"Wang","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/s12967-024-04981-7","article-title":"Engineered bone marrow mesenchymal stem cell-derived exosomes loaded with miR-302 through a cardiomyocyte-specific peptide reduce myocardial ischemia\u2013reperfusion injury","volume":"22","author":"Gu","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"114135","DOI":"10.1016\/j.colsurfb.2024.114135","article-title":"Engineered nanovesicles mediate cardiomyocyte survival and neovascularization for the treatment of myocardial infarction","volume":"243","author":"Zhang","year":"2024","journal-title":"Colloids Surf. B Biointerfaces"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"3295","DOI":"10.2147\/IJN.S454277","article-title":"Engineered exosomes with growth differentiation factor-15 overexpression enhance cardiac repair after myocardial injury","volume":"19","author":"Zou","year":"2024","journal-title":"Int. J. Nanomed."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"eaaz0952","DOI":"10.1126\/sciadv.aaz0952","article-title":"Nanovesicles derived from iron oxide nanoparticle-incorporated mesenchymal stem cells for cardiac repair","volume":"6","author":"Lee","year":"2020","journal-title":"Sci. Adv."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s12015-021-10289-6","article-title":"Extracellular vesicles as a cell-free therapy for cardiac repair: A systematic review and meta-analysis of randomized controlled preclinical trials in animal myocardial infarction models","volume":"18","author":"Khan","year":"2022","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"eaat9683","DOI":"10.1126\/scitranslmed.aat9683","article-title":"An off-the-shelf artificial cardiac patch improves cardiac repair after myocardial infarction in rats and pigs","volume":"12","author":"Huang","year":"2020","journal-title":"Sci. Transl. Med."},{"key":"ref_95","first-page":"324","article-title":"Ameliorating impaired cardiac function in myocardial infarction using exosome-loaded gallic acid-containing polyurethane scaffolds","volume":"33","author":"Das","year":"2023","journal-title":"Bioact. Mater."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"56892","DOI":"10.1021\/acsami.1c16481","article-title":"Restoring cardiac functions after myocardial infarction-ischemia\/reperfusion via an exosome-anchoring conductive hydrogel","volume":"13","author":"Zou","year":"2021","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_97","first-page":"3314","article-title":"Local administration of porcine immunomodulatory, chemotactic, and angiogenic extracellular vesicles using engineered cardiac scaffolds for myocardial infarction","volume":"6","author":"Calle","year":"2021","journal-title":"Bioact. Mater."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1007\/s12015-021-10186-y","article-title":"Bioactive scaffolds in stem cell-based therapies for myocardial infarction: A systematic review and meta-analysis of preclinical trials","volume":"18","author":"Khan","year":"2022","journal-title":"Stem Cell Rev. Rep."},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Gao, H., Liu, S., Qin, S., Yang, J., Yue, T., Ye, B., Tang, Y., Feng, J., Hou, J., and Danzeng, D. (2024). Injectable hydrogel-based combination therapy for myocardial infarction: A systematic review and meta-analysis of preclinical trials. BMC Cardiovasc. Disord., 24.","DOI":"10.1186\/s12872-024-03742-0"},{"key":"ref_100","first-page":"119","article-title":"Injectable conductive gelatin methacrylate\/oxidized dextran hydrogel encapsulating umbilical cord mesenchymal stem cells for myocardial infarction treatment","volume":"13","author":"Zhu","year":"2021","journal-title":"Bioact. Mater."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"4656","DOI":"10.7150\/thno.72289","article-title":"Acellular cardiac scaffolds enriched with MSC-derived extracellular vesicles limit ventricular remodelling and exert local and systemic immunomodulation in a myocardial infarction porcine model","volume":"12","author":"Teis","year":"2022","journal-title":"Theranostics"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1089\/scd.2021.0084","article-title":"Hypoxic stem cell-derived extracellular vesicles for cardiac repair in preclinical animal models of myocardial infarction: A meta-analysis","volume":"30","author":"Gao","year":"2021","journal-title":"Stem Cells Dev."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"e10697","DOI":"10.1002\/btm2.10697","article-title":"In situ-crosslinked zippersomes enhance cardiac repair by increasing accumulation and retention","volume":"9","author":"Jasiewicz","year":"2024","journal-title":"Bioeng. Transl. Med."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"La Mantia, D., Bernardini, C., Zannoni, A., Salaroli, R., Wang, C., Bencivenni, S., and Forni, M. (2022). Efficacy of stem cell therapy in large animal models of ischemic cardiomyopathies: A systematic review and meta-analysis. Animals, 12.","DOI":"10.3390\/ani12060749"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Hsiao, L.C., Lin, Y.N., Shyu, W.C., Ho, M., Lu, C.R., Chang, S.S., Wang, Y.C., Chen, J.Y., Lu, S.Y., and Wu, M.Y. (2022). First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarction. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.961920"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s13287-023-03495-1","article-title":"Effect of Once versus Twice Intracoronary Injection of Allogeneic-Derived Mesenchymal Stromal Cells after Acute Myocardial Infarction: BOOSTER-TAHA7 Randomized Clinical Trial","volume":"14","author":"Attar","year":"2023","journal-title":"Stem Cell Res. Ther."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"3702","DOI":"10.1093\/eurheartj\/ehaa651","article-title":"The effect of intracoronary infusion of bone marrow-derived mononuclear cells on all-cause mortality in acute myocardial infarction: The BAMI trial","volume":"41","author":"Mathur","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1002\/ehf2.13786","article-title":"Five-year follow-up of intracoronary autologous cell therapy in acute myocardial infarction: The REGENERATE-AMI trial","volume":"9","author":"Mathur","year":"2022","journal-title":"ESC Heart Fail."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1186\/s13287-025-04678-8","article-title":"Stem cell therapy for myocardial infarction and atherosclerosis: Mechanisms, challenges, and future directions","volume":"16","author":"Wan","year":"2025","journal-title":"Stem Cell Res. Ther."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e20582","DOI":"10.7717\/peerj.20582","article-title":"Advances in novel biomaterials for cardiovascular tissue engineering and regenerative medicine","volume":"14","author":"Pan","year":"2026","journal-title":"PeerJ"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/MS9.0000000000004284","article-title":"Smart bioactive hydrogels for myocardial infarction repair: A multifunctional approach integrating stimuli-responsive drug delivery, electroconductivity, and real-time biosensing","volume":"88","author":"Nazir","year":"2025","journal-title":"Ann. Med. Surg."}],"container-title":["Biomimetics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2313-7673\/11\/8\/583\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:39:22Z","timestamp":1786966762000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2313-7673\/11\/8\/583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,15]]},"references-count":111,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["biomimetics11080583"],"URL":"https:\/\/doi.org\/10.3390\/biomimetics11080583","relation":{},"ISSN":["2313-7673"],"issn-type":[{"value":"2313-7673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,15]]}}}