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Cardiovascular disease is the leading cause of morbidity and mortality in the world and present a weighty socio-economic burden on an already strained global health system1,17. Cardiac tissue engineering has two distinct goals: (1) to regenerate damaged myocardium after ischemic disease or cardiomyopathy or (2) to create a high fidelity model of the heart for in vitro drug screening or disease modeling.
The heart is a complex organ that must work constantly to supply blood to the body. Densely packed laminar structures of cardiomyocytes and supportive tissues are arranged in helical patterns throughout the heart wall18,19. The heart is also electromechanically coupled20 in a highly coordinated fashion to efficiently eject blood to the body21. Several major hurdles remain to be addressed, however, before nature’s intricate design can reliably be recapitulated in vitro. First, although robust cardiomyocyte differentiation methods continue to be developed22, hPSC-CMs still exhibit rather immature phenotypes. Their electromechanical properties and morphology most closely match fetal levels23. Second, when kept in traditional culture conditions, both stem cell-derived and primary cardiomyocytes fail to assemble into native, tissue-like structures. Rather, cells become randomly oriented and do not exhibit the banded rod-shaped appearance of adult myocardium24.
The extracellular matrix (ECM) environment with which cells interact plays a significant role in numerous cellular processes11,13,25. The ECM consists of complex, well-defined molecular and topographical cues that significantly influence the structure and function of cells6,26. Within the heart, cellular alignment closely follows the underlying nanometer scale ECM fibers2. The impact of these nanotopographical cues on cell and tissue function, however, is far from completely understood. Preliminary studies of nanometer scale cell-biomaterial interaction indicate the potential importance and impact of sub-micron topographical cues for cell signaling27, adhesion28-30, growth31, and differentiation32,33. However, due to the difficulty in developing reproducible and scalable nanofabricated substrates, such studies could not reproduce the multi-scale cellular effects of the complex in vivo ECM environment. In this protocol, a straightforward and cost-effective nanofabrication technique to produce cell culture scaffolds mimicking native cardiac ECM fiber alignment is described, allowing for a wide range of novel investigations of cardiomyocyte-biomaterial interactions. Understanding how cardiomyocytes interact with the nanoscale ECM environment could allow for the ability to control cellular behavior to more closely mimic native tissue function. Furthermore, cell monolayers are a simplified experimental system compared to 3D structures but still exhibit complex multi-cellular behavior for insightful investigations and functional screening2,34-36. Finally, such scaffolds could be used to improve cellular graft function when implanted into the heart for regenerative purposes37.