Decellularized cardiac ECM: A tissue-specific bioactive platform for drug release and cell delivery.

Decellularized extracellular matrix (dECM) materials derived from cardiac tissues have emerged as multifunctional biomaterials that recapitulate native microenvironmental cues while serving as controlled-release reservoirs of therapeutic agents and cells for cardiac repair. Recent advances have demonstrated that decellularized cardiac ECM (dcECM) hydrogels and patches can localize the release of angiogenic peptides, growth factors, or genes to promote neovascularization and mitigate adverse remodeling. Simultaneously, dcECM platforms have been applied to improve the survival and engraftment of stem cells, cardiomyocytes (CMs), and cardiac progenitor cells (CPCs) in infarcted myocardium, facilitating paracrine signaling and immune modulation. This review summarizes recent progress in the design and translational development of dcECM-based drug and cell delivery strategies for cardiac repair. We emphasized the interactions between matrix composition, its capacity to protect therapeutic factors and enhance cell retention, and therapeutic release profiles that collectively regulate cardiac tissue repair outcomes and highlighted emerging clinical applications and regulatory challenges for next-generation dcECM-based therapeutics.