The Effect of Mechanical Stretch on the Maturation of Cardiomyocytes.

Cardiovascular disease is the leading cause of death worldwide, with myocardial infarction being the most common type among these conditions. Therefore, effective treatments for myocardial infarction are urgently needed. The regenerative capacity of cardiomyocytes (CMs) is limited, prompting an increasing number of research teams to explore cell replacement therapy as a novel approach for treating this condition. However, CMs derived from stem cells or neonatal mouse CMs often retain an immature phenotype, hindering the advancement of cell replacement therapies. Recent years have seen various methods developed for engineering cardiac tissue to enhance the maturation of induced CMs, including mechanical and biochemical stimulation, as well as co-culture techniques. Mechanical stretching, a key mechanical stimulus that simulates the physiological growth environment of the myocardium, plays a crucial role in promoting CM maturation. This review provides a comprehensive overview of the effects of mechanical stretch on CMs, discussing its mechanisms, effects, signal transduction pathways, and stimulation devices (Graphical Abstract). While mechanical stretch effectively enhances the structural and functional maturation of induced CMs, it may not be entirely sufficient on its own. Therefore, investigating combinations of multiple stimulation methods could represent a vital future research direction in cardiac tissue engineering aimed at promoting CM maturation.