A matrix-mimicking bioadhesive epicardium for tunable modulation of biomechanics in the acutely infarcted heart

Mitigating adverse tissue remodeling after a heart attack or myocardial infarction (MI) is critical to prevent the development of heart failure. Among various post-MI treatment strategies, mechanical reinforcement of the infarcted region with epicardial patches has promise due to its consistent improvement of chronic cardiac function and its drug- or biologic-free nature. However, despite the variety of patch materials studied to date, the lack of a programmable platform that predictably modifies early-stage cardiac biomechanics to different degrees has prevented further optimization of this strategy. Here, we introduce the matrix-mimicking bioadhesive epicardium (MMBE), a platform that can be rationally designed to achieve a wide range of anisotropic mechanical properties to offer quantifiable mechanical reinforcement of the heart upon application. The platform synergistically combines fully programmable direct-ink-writing of extracellular matrix-inspired crimped fibers and a bioadhesive for sutureless integration to the epicardium. The MMBE platform achieves an array of matrix-mimicking mechanical properties and acute modulation of cardiac biomechanics using numerical analysis, in silico studies and experimental characterizations. Furthermore, the feasibility of the MMBE platform in an in vivo rat model of MI is demonstrated. The MMBE platform can be used to systematically identify patch design parameters that alter post-MI remodeling without introducing confounding biological variables.