Acellular epicardial patches that treat myocardial infarction by increasing the mechanical integrity of damaged left ventricular tissues exhibit widely scattered therapeutic efficacy. Here, we introduce a viscoelastic adhesive patch, made of an ionically crosslinked transparent hydrogel, that accommodates the cyclic deformation of the myocardium and outperforms most existing acellular epicardial patches in reversing left ventricular remodelling and restoring heart function after both acute and subacute myocardial infarction in rats. The superior performance of the patch results from its relatively low dynamic modulus, designed at the so-called ‘gel point’ via finite-element simulations of left ventricular remodelling so as to balance the fluid and solid properties of the material.
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All data supporting the findings of this study are available within the paper and its Supplementary Information files. Source data for the figures are available from the corresponding authors upon reasonable request. The RNA sequence data have been deposited in the National Center for Biotechnology Information Sequence Read Archive, with accession code SRP187341.
The FEBio code is available upon reasonable request.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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We thank Y. Guan, A. J. Clasky and Y. Mao for material fabrication and characterization assistance, G. A. Holzapfel for discussions on the modelling methods, Y. Zhao for artwork, J. Wu for assistance with haemodynamics measurements, and C. Liu and H. Chen for assistance with rat surgery and echocardiology measurements. This work has been supported by the National Natural Science Foundation of China (81622032 and 51672184 to L.Y., 31571527 to N.S. and 81501858 to X.L.), National Science Foundation (CMMI-1562904 to H.G.), Jiangsu Innovation and Entrepreneurship Program (to L.Y.), National Key R&D Program of China (2016YFC1000500 and 2016YFC1305100 to N.S., and 2014CB748600 to L.Y.), Science and Technology Commission of Shanghai Municipality (numbers 17XD1400300 and 17JC1400200 to N.S.) and Priority Academic Program Development of Jiangsu Higher Education Institutions (to L.Y.).
Supplementary methods, discussion, figures, tables, references and video captions.
Stretching of GPAP with a tweezer.
Demonstration of patching GPAP onto a rat heart.
Injection of GPAP through a syringe needle with an inner diameter of 1.2 mm.