With permanent heart muscle injury or death, myocardial
infarction
(MI) is complicated by inflammatory, proliferation and remodeling
phases from both the early ischemic period and subsequent infarct
expansion. Though in situ re-establishment of blood flow to the infarct
zone and delays of the ventricular remodeling process are current
treatment options of MI, they fail to address massive loss of viable
cardiomyocytes while transplanting stem cells to regenerate heart
is hindered by their poor retention in the infarct bed. Equipped with
heart-specific mimicry and extracellular matrix (ECM)-like functionality
on the network structure, hydrogels leveraging tissue-matching biomechanics
and biocompatibility can mechanically constrain the infarct and act
as localized transport of bioactive ingredients to refresh the dysfunctional
heart under the constant cyclic stress. Given diverse characteristics
of hydrogel including conductivity, anisotropy, adhesiveness, biodegradability,
self-healing and mechanical properties driving local cardiac repair,
we aim to investigate and conclude the dynamic balance between ordered
architectures of hydrogels and the post-MI pathological milieu. Additionally,
our review summarizes advantages of heart-tailored architectures of
hydrogels in cardiac repair following MI. Finally, we propose challenges
and prospects in clinical translation of hydrogels to draw theoretical
guidance on cardiac repair and regeneration after MI.