van Doorn Elisa C H, Amesz Jorik H, Manintveld Olivier C, de Groot Natasja M S, Essers Jeroen, Shin Su Ryon, Taverne Yannick J H J
Translational Cardiothoracic Surgery Research Lab, Department of Cardiothoracic Surgery, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.
Department of Cardiology, Cardiovascular Institute, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands.
Bioengineering (Basel). 2024 Dec 3;11(12):1220. doi: 10.3390/bioengineering11121220.
Heart failure is characterized by intricate myocardial remodeling that impairs the heart's pumping and/or relaxation capacity, ultimately reducing cardiac output. It represents a major public health burden, given its high prevalence and associated morbidity and mortality rates, which continue to challenge healthcare systems worldwide. Despite advancements in medical science, there are no treatments that address the disease at its core. The development of three-dimensional engineered models that closely mimic the (patho)physiology and drug responses of the myocardium has the potential to revolutionize our insights and uncover new therapeutic avenues. Key aspects of these models include the precise replication of the extracellular matrix structure, cell composition, micro-architecture, mechanical and electrical properties, and relevant physiological and pathological stimuli, such as fluid flow, mechanical load, electrical signal propagation, and biochemical cues. Additionally, to fully capture heart failure and its diversity , it is crucial to consider factors such as age, gender, interactions with other organ systems and external influences-thereby recapitulating unique patient and disease phenotypes. This review details these model features and their significance in heart failure research, with the aim of enhancing future platforms that will deepen our understanding of the disease and facilitate the development of novel, effective therapies.
心力衰竭的特征是复杂的心肌重塑，这会损害心脏的泵血和/或舒张能力，最终降低心输出量。鉴于其高患病率以及相关的发病率和死亡率，它是一个重大的公共卫生负担，持续对全球医疗系统构成挑战。尽管医学取得了进步，但尚无针对该疾病核心的治疗方法。三维工程模型的发展能够紧密模拟心肌的（病理）生理学和药物反应，有可能彻底改变我们的认知并发现新的治疗途径。这些模型的关键方面包括精确复制细胞外基质结构、细胞组成、微观结构、机械和电学特性，以及相关的生理和病理刺激，如流体流动、机械负荷、电信号传播和生化信号。此外，为了全面了解心力衰竭及其多样性，考虑年龄、性别、与其他器官系统的相互作用以及外部影响等因素至关重要，从而再现独特的患者和疾病表型。这篇综述详细阐述了这些模型特征及其在心力衰竭研究中的意义，旨在改进未来的平台，加深我们对该疾病的理解，并促进新型有效疗法的开发。
