Applications of elastic and conductive hydrogels in myocardial infarction repair

Myocardial infarction (MI) is one of the leading causes of death worldwide, posing a serious threat to global human health. The heart failure that often follows MI remains a major contributor to mortality. Therefore, the development of more effective treatment approaches or intervention strategies aimed at improving patients' quality of life is of great clinical significance. The emergence and advancement of cardiac tissue engineering have opened new avenues and have demonstrated promising results in practical applications. Among various biomaterials, elastic and conductive hydrogels (ECHs) have attracted extensive attention due to their excellent biocompatibility, tunable elasticity, and the potential for electrical integration with human myocardium. By virtue of their unique properties, ECHs synergize with functional cells, bioactive molecules, and therapeutic agents to markedly improve outcomes in MI repair, effectively serving as a valuable adjunct to these therapies. Rooted in the practical needs of MI therapy, this review systematically discusses the design principles of ECHs, strategies for enhancing their mechanical and electrical properties, and their synergistic applications with therapeutic cells and bioactive molecules. It further outlines recent advances and persistent challenges, offering theoretical insights and strategic directions for future innovation and clinical translation. • Systematic review of elasticity enhancement strategies in hydrogels for MI therapy. • Classification and key applications of conductive materials in ECHs for MI repair • Highlight the mechanism of conductivity improving the therapeutic effect. • Mechanistically analyzed the enhancement of therapeutic repair effects by ECHs on MI. • Objective analysis of the challenges and opportunities faced by future for co therapy.