Bioceramics-enhanced patch activates epicardial epithelial-to-mesenchymal transition via Notch pathway for cardiac repair

Engineered cardiac patches (ECPs) introduced functional factors that offer a promising strategy for the treatment of myocardial infarction (MI). Silicate bioceramics have received widespread attention because of their great potential in the tissue repair field. Inspired by the biological functions of inorganic ions on the cardiovascular system, we prepared an ECP containing lithium magnesium silicon bioceramics (LMS) particles. The release of multiple bioactive ions from LMS-containing ECPs could facilitate the functionalization and intercellular communication between cardiomyocytes (CMs). Furthermore, it was demonstrated that the LMS-containing ECPs could promote epicardial cell epithelial-to-mesenchymal transition (EMT) through the Notch pathway and paracrine, which efficiently repaired damaged CMs. In vivo, the regenerative microenvironment induced by LMS-containing ECPs restored normal electrical impulse propagation across scar tissue, activated islands of surviving myocardium, and improved cardiac function. Overall, this study constructed a bioceramics-enhanced ECP, which could promote cardiac repair by activating epicardial EMT, providing a promising strategy for MI repair.