Nanotechnology-Driven cardiac tissue engineering and 3D bioprinting: Mechanistic insights into myocardial repair and regeneration

Ischemic heart disease is the leading cause of death worldwide, largely due to the limited regenerative capacity of the myocardium after infarction. Conventional treatments alleviate symptoms but cannot restore functional cardiac tissue. Recent advances in nanotechnology and 3D bioprinting offer transformative strategies for cardiac regeneration. Nanostructured biomaterials, oxygen-generating nanoparticles, and nanoformulated growth factors enhance angiogenesis, paracrine signaling, and cell survival, while bioprinting provides patient-specific constructs with precise cellular and matrix organization. This review highlights how nanoengineered hydrogels, exosome-loaded scaffolds, and conductive composites improve vascularization, alignment, and contractility. We emphasize the novelty of integrating nanotechnology with 3D bioprinting to replicate native myocardial microarchitecture and function, a critical step toward clinically relevant cardiac constructs. Despite encouraging preclinical results, barriers remain, including vascularization, immune compatibility, and mechanical integration. Addressing these challenges will be key to translating biofabricated therapies into practice.