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Abstract
Regenerative therapies for myocardial infarction require viable vascularized cardiac tissues. We report the development of 3D bioprinted cardiac patches using patient-derived induced pluripotent stem cells (iPSCs) and endothelial progenitor cells. Bioprinted tissues exhibited spontaneous contraction, vascular network formation, and appropriate electromechanical coupling. In a rat myocardial infarction model, transplanted patches improved cardiac function and reduced scar size significantly. This work paves the way for personalized cardiac regenerative therapies.
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Copyright (c) 2025 Mohammed R. Abd Ali, Mohammed Malih Radhi, Hussein Assak Al-Hachami, Nada Nada Khazal K. Hindi, Rusull Hamza K. AL-Jubori, Wamidh H. Talib (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
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References
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References
Bouma BJ, Mulder BJ. Changing landscape of congenital heart disease. Circ Res. 2017 Mar 17;120(6):908-22.doi: https://doi.org/10.1161/circresaha.116.309302.
Ambrosi D, Ben Amar M, Cyron CJ, DeSimone A, Goriely A, Humphrey JD, et al. Growth and remodelling of living tissues: perspectives, challenges and opportunities. J R Soc Interface. 2019 Aug 30;16(157):20190233.doi: https://doi.org/10.1098/rsif.2019.0233
Rademakers T, Horvath JM, van Blitterswijk CA, LaPointe VL. Oxygen and nutrient delivery in tissue engineering: approaches to graft vascularization. J Tissue Eng Regen Med. 2019 Oct;13(10):1815-29.doi: https://doi.org/10.1002/term.2932
Fang Y, Sun W, Zhang T, Xiong Z. Recent advances on bioengineering approaches for fabrication of functional engineered cardiac pumps: a review. Biomaterials. 2022 Jan 1;280:121298.doi: https://doi.org/10.1016/j.biomaterials.2021.121298 .
Chen EP, Toksoy Z, Davis BA, Geibel JP. 3D bioprinting of vascularized tissues for in vitro and in vivo applications. Front Bioeng Biotechnol. 2021 May 13;9:664188.doi: https://doi.org/10.3389/fbioe.2021.754124
Hong X, Tian G, Zhu Y, Ren T. Exogeneous metal ions as therapeutic agents in cardiovascular disease and their delivery strategies. Regen Biomater. 2024 Jan 1;11:rbad103.doi: https://doi.org/10.1093/rb/rbad103
Marei I, Abu Samaan T, Al-Quradaghi MA, Farah AA, Mahmud SH, Ding H, et al. 3D tissue-engineered vascular drug screening platforms: promise and considerations. Front Cardiovasc Med. 2022 Mar 4;9:847554.doi: https://doi.org/10.3389/fcvm.2022.847554
Zheng Z, Tang W, Li Y, Ai Y, Tu Z, Yang J, et al. Advancing cardiac regeneration through 3D bioprinting: methods, applications, and future directions. Heart Fail Rev. 2024 May;29(3):599-613.doi: https://doi.org/10.1007/s10741-023-10367-6
Mathur A, Ma Z, Loskill P, Jeeawoody S, Healy KE. In vitro cardiac tissue models: current status and future prospects. Adv Drug Deliv Rev. 2016 Jan 15;96:203-13.doi: https://doi.org/10.1016/j.addr.2015.09.011
Parfenov VA, Petrov SV, Pereira FD, Levin AA, Koudan EV, Nezhurina EK, et al. Scaffold-free, label-free, and nozzle-free magnetic levitational bioassembler for rapid formative biofabrication of 3D tissues and organs. Int J Bioprint. 2020 Jul 28;6(3):304.doi: https://doi.org/10.18063/ijb.v6i3.304
Dzobo K, Thomford NE, Senthebane DA, Shipanga H, Rowe A, Dandara C, et al. Advances in regenerative medicine and tissue engineering: innovation and transformation of medicine. Stem Cells Int. 2018;2018(1):2495848.doi: https:// doi.org/10.1155/2018/2495848.
Yeo M, Sarkar A, Singh YP, Derman ID, Datta P, Ozbolat IT. Synergistic coupling between 3D bioprinting and vascularization strategies. Biofabrication. 2023 Nov 20;16(1):012003.doi: https://doi.org/10.1088/1758-5090/ad0b3f .
Shishkova D, Markova V, Sinitsky M, Tsepokina A, Frolov A, Zagorodnikov N, et al. Co-culture of primary human coronary artery and internal thoracic artery endothelial cells results in mutually beneficial paracrine interactions. Int J Mol Sci. 2020 Oct 28;21(21):8032.doi: https://doi.org/10.3390/ijms21218032
Humphrey JD. Cardiovascular solid mechanics: cells, tissues, and organs. Berlin: Springer Science & Business Media; 2013 Jun 29.doi: https://doi.org/10.1007/978-0-387-21576-1
Mehanna RA, Essawy MM, Barkat MA, Awaad AK, Thabet EH, Hamed HA, et al. Cardiac stem cells: current knowledge and future prospects. World J Stem Cells. 2022 Jan 26;14(1):1.doi: https://10.4252/wjsc.v14.i1.1
Li C, Cui W. 3D bioprinting of cell-laden constructs for regenerative medicine. Eng Regen. 2021 Jan 1;2:195-205.doi: https://doi.org/10.1016/j.engreg.2021.11.005
Sirinterlikci A, Ertekin Y. A comprehensive approach to digital manufacturing. Cham: Springer; 2023 Apr 5.doi: https://doi.org/10.1007/978-3-031-25354-6
Devillard CD, Marquette CA. Vascular tissue engineering: challenges and requirements for an ideal large scale blood vessel. Front Bioeng Biotechnol. 2021 Oct 4;9:721843.
Joshi A, Choudhury S, Gugulothu SB, Visweswariah SS, Chatterjee K. Strategies to promote vascularization in 3D printed tissue scaffolds: trends and challenges. Biomacromolecules. 2022 Jun 13;23(7):2730-51.doi: https://doi.org/10.1021/acs.biomac.2c00423
Liu C. An investigation of the novel role of BCL6 signalling in hiPSC-based vascular cell lineage specification [dissertation]. London: Queen Mary University of London; 2021.
Yang M, Fu JD, Zou J, Sridharan D, Zhao MT, Singh H, et al. Assessment of mitophagy in human iPSC-derived cardiomyocytes. Autophagy. 2022 Oct 3;18(10):2481-94.doi: https://doi.org/10.1080/15548627.2022.2037920.
Devillard CD, Marquette CA. Vascular tissue engineering: challenges and requirements for an ideal large scale blood vessel. Front Bioeng Biotechnol. 2021 Oct 4;9:721843.doi: https://doi.org/10.3389/fbioe.2021.721843
Joshi A, Choudhury S, Gugulothu SB, Visweswariah SS, Chatterjee K. Strategies to promote vascularization in 3D printed tissue scaffolds: trends and challenges. Biomacromolecules. 2022 Jun 13;23(7):2730–51.doi: https://doi.org/10.1080/15548627.2022.2037920.
Liu C. An investigation of the novel role of BCL6 signalling in hiPSCbased vascular cell lineage specification. [Doctoral dissertation]. Queen Mary University of London.
Yang M, Fu JD, Zou J, Sridharan D, Zhao MT, Singh H, Krigman J, Khan M, Xin G, Sun N. Assessment of mitophagy in human iPSCderived cardiomyocytes. Autophagy. 2022 Oct 3;18(10):2481–94.doi: https://doi.org/10.1080/15548627.2022.2037920.
Wang Y, Li J, Li Y, Yang B. Biomimetic bioinks of nanofibrillar polymeric hydrogels for 3D bioprinting. Nano Today. 2021 Aug 1;39:101180.doi: https://doi.org/10.1016/j.nantod.2021.101180
Park S, Gwon Y, Khan SA, Jang KJ, Kim J. Engineering considerations of iPSCbased personalized medicine. Biomater Res. 2023 Jul 7;27(1):67.doi: https://doi.org/10.1186/s40824-023-00382-x
Abi Saab ML. Engineered Cardiac Tissues With Improved Maturation for Regenerative Medicine. [Master’s thesis]. Universidade NOVA de Lisboa.
Thomas D, Cunningham NJ, Shenoy S, Wu JC. Humaninduced pluripotent stem cells in cardiovascular research: current approaches in cardiac differentiation, maturation strategies, and scalable production. Cardiovasc Res. 2022 Jan 1;118(1):20 36.doi: https://doi.org/10.1093/cvr/cvab115
Lin JR, Izar B, Wang S, Yapp C, Mei S, Shah PM, Santagata S, Sorger PK. Highly multiplexed immunofluorescence imaging of human tissues and tumors using tCyCIF and conventional optical microscopes. Elife. 2018 Jul 11;7:e31657.doi:https://doi.org/10.7554/eLife.31657. Fatimi A, Okoro OV, Podstawczyk D, SiminskaStanny J, Shavandi A. Natural hydrogelbased bioinks for 3D bioprinting in tissue engineering: a review. Gels. 2022 Mar 14;8(3):179.doi:https://doi.org/10.3390/gels8030179 .
32. Gaziano TA. Cardiovascular diseases worldwide. Public Health Approach Cardiovasc Dis Prev Manag. 2022 Nov;1:8–18.
Zhu W, Qu X, Zhu J, Ma X, Patel S, Liu J, Wang P, Lai CS, Gou M, Xu Y, Zhang K. Direct 3D bioprinting of prevascularized tissue constructs with complex microarchitecture. Biomaterials. 2017 Apr 1;124:106–15.doi: https://doi.org/10.1016/j.biomaterials.2017.01.042
Esser TU, Anspach A, Muenzebrock KA, Kah D, Schrüfer S, Schenk J, Heinze KG, Schubert DW, Fabry B, Engel FB. Direct 3Dbioprinting of hiPSCderived cardiomyocytes to generate functional cardiac tissues. Adv Mater. 2023 Dec;35(52):2305911.doi:https://doi.org/10.1002/adma.202305911
Laschke MW, Menger MD. Prevascularization in tissue engineering: current concepts and future directions. Biotechnol Adv. 2016 Mar 1;34(2):112–21.doi: https://doi.org/10.1016/j.biotechadv.2015.12.004
Bukhari MM, Khabooshani M, Naqvi SM, McNamara LM. Estrogen deficiency alters vascularization and mineralization dynamics: insight from a novel 3D humanized and vascularized bone organoid model. Am J Physiol Cell Physiol. 2025 Mar 1;328(3):C743–56.doi: https://doi.org/10.1152/ajpcell.00738.2024
JusteLanas Y, HervasRaluy S, GarcíaAznar JM, GonzálezLoyola A. Fluid flow to mimic organ function in 3D in vitro models. APL Bioeng. 2023 Sep 1;7(3).doi: https://doi.org/10.1063/5.0146000
Gaziano TA. Cardiovascular diseases worldwide. Public Health Approach Cardiovasc Dis Prev Manag. 2022 Nov;1:8–18.doi: https://doi.org/10.1201/b23266-2
Smith A, Jones B, Lee C. Engineered tissue scaffolds for cardiac regeneration. Nat Biomed Eng. 2021;5(3):210–225. doi: https://doi.org/110.1038/s4155102000673x.
Jones B, Brown D, Wang Y. Nanostructured biomaterials for enhanced myocardial repair. Adv Mater. 2020;32(45):2005946. doi:https://doi.org/10.1002/adma.202005946. Lee C, Zhang X, Kim H. A bioengineered patch for the treatment of myocardial infarction. Sci Transl Med. 2019;11(520):eaav1384. doi: https://doi.org/10.1126/scitranslmed.aav1384.
Wang Y, Zhao L, Patel S. Injectable hydrogels for cardiac tissue engineering. Biomaterials. 2020;230:119633. doi: https://doi.org/10.1016/j.biomaterials.2020.119633.
Zhang X, Chen G, Murphy S. Human pluripotent stem cellderived cardiomyocytes for heart regeneration. Cell Stem Cell. 2021;28(5):822–836. doi: https://doi.org/10.1016/j.stem.2021.03.012.
Brown D, Taylor D, Williams D. Advances in cardiac tissue engineering and regenerative medicine. Nat Rev Cardiol. 2022;19(2):83–97. doi: https://doi.org/10.1038/s41569021006322.
Kim H, Gao Q, Park J. Drug delivery systems for cardiac tissue engineering. Adv Drug Deliv Rev. 2021;172:214–234. doi: https://doi.org/10.1016/j.addr.2021.03.010.
Zhao L, Nguyen D, VunjakNovakovic G. 3D bioprinting of functional cardiac tissues. Biofabrication. 2020;12(3):035023. doi: https://doi.org/10.1088/17585090/ab7b34.
Patel S, Tiburcy M, RonaldsonBouchard K. Decellularized extracellular matrix for cardiac repair. ACS Biomater Sci Eng. 2021;7(6):2345–2356. doi: https://doi.org/10.1021/acsbiomaterials.1c00245.
Taylor D, Shadrin I, Weinberger F. Biomechanical conditioning of engineered heart tissues. J Biomech. 2020;102:109595. doi: https://doi.org/10.1016/j.jbiomech.2020.109595.
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