This Research Topic is Volume II of a series. The previous volume, which has attracted 151 authors can be found here: Advanced Therapies for Cardiac Regeneration.

Myocardial infarction is caused by the obstruction of coronary arteries, resulting in the death of approximately 1 billion cardiomyocytes in the left ventricle within a few hours, acute inflammation, and degradation of the cardiac extracellular matrix, with the formation of a fibrotic scar. Fibrotic tissue is mechanically stiffer than healthy cardiac tissue, it is mainly populated by cardiac fibroblasts, and lacks beating cardiomyocytes. The cardiac scar may undergo continuous remodeling, leading to left ventricle dilation and progressive congestive heart failure, which is the current leading cause of mortality and morbidity in the industrialized world. The only standard therapy addressing the irreversible loss of functional cardiomyocytes is heart transplantation, which however is limited by donor loss and the need for life-long immunosuppression. An ideal cardiac regenerative medicine strategy should replace lost cardiomyocytes and recover myocardial functional contractility.

To this purpose, cell-based regenerative therapies and tissue-engineered scaffolds/patches have been investigated for years, however, their success has been limited by the poor grafting, survival, and integration of the implanted cells into the infarcted tissue and the limited endogenous regenerative potential of the adult heart. Hence, the regeneration of a damaged heart still remains a major clinical challenge with a deep social and economic impact. Outcomes of cell therapies could be improved through the local implantation of cell-populated scaffolds or hydrogels reaching higher cell retention, survival, and integration with the host tissue. Electrically conductive biomaterials and stretchable patches, based on elastomeric materials and/or specific geometrical patterns, are also attracting growing interest, for their ability to trigger cardiomyocyte maturation and electromechanical coupling with the host tissue. Other cardiac regeneration strategies include cell reprogramming approaches, which are aimed at directly converting cardiac fibroblasts into induced cardiomyocytes or at stimulating cardiomyocyte proliferation. Over the last decade, the traditional cardiac tissue engineering strategies have also been translated towards the design of in vitro bioengineered cardiac tissue models for basic research purposes, toxicity assessment, innovative therapies evaluation, and drug screening.

This Research Topic is aimed at the publication of interdisciplinary studies on advanced therapies for cardiac regeneration. Through a collection of original papers and review articles, this Research Topic aims to collect the latest state-of-the-art ideas, concepts, findings, achievements, and future projections and promote awareness of these multidisciplinary studies, thereby encouraging bridging the gap between medicine, pharmacy, material sciences, biomechanics and engineering for research collaboration across fields to address cardiac regeneration. Clinicians and researchers are invited to contribute with their original evidence-based articles, as well as critical literature review manuscripts, summarizing the most recent and exciting innovative developments.

Potential topics include, but are not limited to, the following:
• Basic studies on cell behavior in pathological and healthy cardiac tissue
• Cell therapies for cardiac regeneration
• Scaffolds for cardiac tissue engineering
• Injectable hydrogels for cardiac tissue engineering
• Direct cardiac reprogramming
• Biomaterials in cell differentiation and/or reprogramming
• In vitro tissue-engineering models of healthy and pathological cardiac tissue
• Nanomedicine for gene therapy in cardiac regeneration
• Drug release for cardiac regeneration
• New microfluidic platforms for cardiac differentiation/reprogramming
• Microfluidic models of cardiac tissue

The Research Topic is organized in the framework of the project BIORECAR (grant number: 772168; http://www.biorecar.polito.it/index.html)

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