Logo image
Injectable Shear-Thinning Hydrogels for Minimally Invasive Delivery to Infarcted Myocardium to Limit Left Ventricular Remodeling
Journal article   Open access   Peer reviewed

Injectable Shear-Thinning Hydrogels for Minimally Invasive Delivery to Infarcted Myocardium to Limit Left Ventricular Remodeling

Christopher B Rodell, Madonna E Lee, Hua Wang, Satoshi Takebayashi, Tetsushi Takayama, Tomonori Kawamura, Jeffrey S Arkles, Neville N Dusaj, Shauna M Dorsey, Walter R T Witschey, …
Circulation. Cardiovascular interventions, v 9(10)
Oct 2016
PMID: 27729419
url
https://doi.org/10.1161/circinterventions.116.004058View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open
url
https://doi.org/10.1161/CIRCINTERVENTIONS.116.004058View
Published, Version of Record (VoR) Open

Abstract

Animals Biocompatible Materials Biomechanical Phenomena Biopsy Cross-Linking Reagents - chemistry Disease Models, Animal Echocardiography Finite Element Analysis Hyaluronic Acid - administration & dosage Hyaluronic Acid - chemistry Hydrogels Injections Magnetic Resonance Imaging Male Models, Cardiovascular Myocardial Infarction - diagnostic imaging Myocardial Infarction - drug therapy Myocardial Infarction - pathology Myocardial Infarction - physiopathology Myocardium - pathology Recovery of Function Sheep, Domestic Stroke Volume - drug effects Time Factors Ventricular Function, Left - drug effects Ventricular Remodeling - drug effects
Injectable, acellular biomaterials hold promise to limit left ventricular remodeling and heart failure precipitated by infarction through bulking or stiffening the infarct region. A material with tunable properties (eg, mechanics, degradation) that can be delivered percutaneously has not yet been demonstrated. Catheter-deliverable soft hydrogels with in vivo stiffening to enhance therapeutic efficacy achieve these requirements. We developed a hyaluronic acid hydrogel that uses a tandem crosslinking approach, where the first crosslinking (guest-host) enabled injection and localized retention of a soft (<1 kPa) hydrogel. A second crosslinking reaction (dual-crosslinking) stiffened the hydrogel (41.4±4.3 kPa) after injection. Posterolateral infarcts were investigated in an ovine model (n≥6 per group), with injection of saline (myocardial infarction control), guest-host hydrogels, or dual-crosslinking hydrogels. Computational (day 1), histological (1 day, 8 weeks), morphological, and functional (0, 2, and 8 weeks) outcomes were evaluated. Finite-element modeling projected myofiber stress reduction (>50%; P<0.001) with dual-crosslinking but not guest-host injection. Remodeling, assessed by infarct thickness and left ventricular volume, was mitigated by hydrogel treatment. Ejection fraction was improved, relative to myocardial infarction at 8 weeks, with dual-crosslinking (37% improvement; P=0.014) and guest-host (15% improvement; P=0.058) treatments. Percutaneous delivery via endocardial injection was investigated with fluoroscopic and echocardiographic guidance, with delivery visualized by magnetic resonance imaging. A percutaneous delivered hydrogel system was developed, and hydrogels with increased stiffness were found to be most effective in ameliorating left ventricular remodeling and preserving function. Ultimately, engineered systems such as these have the potential to provide effective clinical options to limit remodeling in patients after infarction.

Metrics

3 Record Views
120 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Logo image