Abstract:The engineering of 3-dimensional (3D) heart muscles has undergone exciting progress for the past decade.Profound advances in human stem cell biology and technology, tissue engineering and material sciences, as well as prevascularization and in vitro assay technologies make the first clinical application of engineered cardiac tissues a realistic option and predict that cardiac tissue engineering techniques will find widespread use in the preclinical research and drug development in the near future. Tasks that need to be solved for this purpose include standardization of human myocyte production protocols, establishment of simple methods for the in vitro vascularization of 3D constructs and better maturation of myocytes, and, finally, thorough definition of the predictive value of these methods for preclinical safety pharmacology. The present article gives an overview of the present state of the art, bottlenecks, and perspectives of cardiac tissue engineering for cardiac repair and in vitro testing. (
Jeffrey Robbins, EditorOriginal received May 24, 2013; revision received July 12, 2013; accepted July 15, 2013. In November 2013, the average time from submission to first decision for all original research papers submitted to Circulation Research was 14.6 days.From the Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.Correspondence to Thomas Eschenhagen, Department of Experimental Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany. E-mail t.eschenhagen@uke.de by guest on May 9, 2018 http://circres.ahajournals.org/
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Hirt et al Cardiac Tissue Engineering 355gyratory shaking of embryonic chicken cardiac myocytes in an Erlenmeyer flask induced the formation of spontaneously beating spheroids with improved functionality when compared with standard 2D-cultured myocytes. This selfassembly is still used in variations to generate cardiac microspheres. 5 Current cardiac tissue engineering methods embark on this endogenous capacity and use engineering techniques to make 3D constructs of the desired size, geometry, and orientation (Table).
Hydrogel TechniqueThe hydrogel method has been pioneered in the 1980s as an advanced culture method for fibroblasts and skeletal muscle cells 6 and gave rise to the first successful cardiac tissue.7 It needs 3 factors: solutions of gelling natural products, such as collagen I, matrigel, fibrin, or mixtures of them; casting molds; and anchoring constructs. The hydrogel entraps cells in a 3D space during gelling, the mold gives the 3D form, and the anchors allow the growing tissue to fix and to develop mechanical tension between ≥2 anchor points. Important aspects of this technique are that the naturally occurring hydrogels stimulate cells to spread and form intercellular connections and that the cells compress the gel, reduce the w...