Mechanical Considerations of Myocardial Tissue and Cardiac Regeneration

Over the past decades, huge scientific efforts have been put into cardiac regeneration strategies. Although several strategies have been accepted for use in clinical practice, none has demonstrated great success in regenerating the cardiac tissue. Therefore, there are still significant challenges in repairing or regenerating cardiac tissue, which serves a predominantly biomechanical function. Furthermore, it is now evident that the mechanobiological interaction between cells and their mechanical environment is essential for tissue function and regeneration. Current cardiac regenerative strategies (i.e. cardiac cell therapy and tissue engineering) are based on administrating new healthy contractile cells within (or without) a healthy scaffold into the diseased cardiac environment. However, these strategies have widely omitted to restore the cellular mechanical environment present after cardiac injury. Therefore, the future cardiac regeneration strategies need to address the challenges of and questions on the role of biomechanics and mechanobiology in cardiac regeneration. This includes measurement and characterisation of multiscale mechanical properties of healthy and diseased cardiac tissue; development of in vitro and in silico models to understand the role of biomechanical factors in tissue regeneration; and translation of this information into the design of novel tissue-engineered strategies. In this chapter, we want to introduce the reader to the importance of mechanical considerations in the design of effective cardiac regeneration strategies.