Development of next generation cardiovascular therapeutics through bio-assisted nanotechnology.

Cardiovascular diseases (CVDs) rank, next to cancer and stroke, among the deadliest diseases in the world. Among the major CVDs, acute myocardial infarction is a life-threatening disorder resulting from permanent damage to the left ventricular cardiac tissue. The major coronary arteries that supply blood to the functional left ventricle become blocked due to thrombotic plaque occlusion. During myocardial ischemia, oxidative stress and free radicals destroy healthy cardiomyocytes, smooth muscle cells, and endothelial cells, followed by degradation of the extracellular matrix, which results in ventricular wall-thinning and dilation. To protect the left ventricle from further damage and to rescue ischemic cardiac tissue, specially designed scaffolds consisting of biological material and nanomaterials have been developed. At the preclinical level, scaffolds loaded with growth factors and cells have been shown to regenerate ischemic tissue into healthy, functional myocardium. In this review, different therapeutic strategies currently available to treat the disease conditions at various stages are discussed, with special emphasis on biomaterials. Recent advancements in cardiovascular therapeutics using graphene and exosomal nanovesicles are discussed in detail. In addition, future directions for the development of next-generation cardiovascular therapeutics with biological and non-biological materials through nano-assisted technology are explored.