Nanotechnology in interventional cardiology: A state-of-the-art review

Abstract

Despite the contemporary techniques and devices available for invasive cardiology procedures, the current diagnostic, and interventional modalities have many shortcomings. As a contemporary cross-disciplinary technique, nanotechnology has demonstrated great potential in interventional cardiology practice. It has a pivotal role in detecting sensitive cardiac biomarkers, nanoparticle-enhanced gadolinium (Gd) contrast to enhance the detection of atherosclerotic cardiovascular disease (ASCVD), and multimodal imaging like including optical coherence tomography (OCT)/infrared luminescence (IR) for coronary plaque characterization. Furthermore, in invasive cardiology, the potential benefit is in miniaturized cardiac implantable electronic devices (CIEDs), including leadless pacemakers and piezoelectric nanogenerators to self-power symbiotic cardiac devices. Nanoparticles are ideal for therapeutic drug delivery systems for atherosclerotic plaque regression, regeneration of fibrotic cardiomyocytes, and disruption of bacterial biofilm to enhance and prolong the effects of antimicrobial agents in infective endocarditis (IE). In summary, nanotechnology-assisted therapies can overtake conventional invasive cardiology and expand the horizon of microtechnology in the diagnosis and treatment of CAD in the foreseeable future.

Keywords: Bacterial biofilm; Gold; Invasive cardiology; Nanoparticles; Optical coherence tomography.

Fig. 1

Main features, classification of nanoparticles, and their interaction with biological systems. The figure shows altered properties of gold nanoparticles after ingestion by Caenorhabditis elegans, altering the genetic makeup and affecting the life cycle, size, and behavior. Adapted from “Main Features of Nanoparticles”, “Classes of Nanoparticles”, “Nanoparticle Interactions with Biological Systems, and Vice Versa”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 2

Schemes of nanotechnology-assisted biosensors for detection of cardiac enzymes. (A) ZnSnO3 perovskite nanomaterial-decorated glassy carbon electrodes were designed as a label-free electrochemical biosensor to detect TnT. This method demonstrated a higher detection sensitivity owing to the ferroelectric property of ZnSnO3 . (B) The gold triangular nanoprism-based localized surface plasmon resonance biosensor monitors cTnT in plasma, serum, and urine. The cTnT assay becomes at least 50-fold more sensitive than other label-free techniques. (C) The nanodiamond hybrid hydrogen-substituted graphdiyne to construct electrochemical aptasensors for detecting Myo and cTnI. Created by J.M. with BioRender.com.

Fig. 3

Measurement of myocardial stress using iodine-doped gold nanoparticles and photoacoustic imaging. Gold nanorods are commonly used as photoacoustic (PA) contrast agents. Previously Au/Ag activatable nanoparticle has been reported to respond to reactive oxygen and nitrogen species (RONS) using PA. RONS can selectively etch off the shell while leaving the gold core intact. The etching results in the reactivation of the PA signal. Iodide-doping of silver increases sensitivity to RONS, thus physiologically relevant levels can be detected in a mouse model. Adapted from “Iodide-Doped Gold Nanoparticles to Measure Oxidative Stress Using Photo-Acoustic Imaging (PA)”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 4

Biofilm formation cycle and therapeutic target sites for biofilm disruption by nanoparticles in endocarditis. Adapted from “Biofilm Formation Cycle”, “anti-Biofilm Therapeutic Target Sites”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 5

Nanoparticles (sHDL nanodiscs) are used as therapeutic carrier agents used to enhance cholesterol transport and reduction of coronary plaques, gene modulation for decreased plaque accumulation, and apoptosis of damaged cardiomyocytes for regeneration of new cells. Adapted from “sHDL Nanodiscs as therapeutic and Carrier Agents”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 6

A look into the organ decellularization for regeneration of new cells with the help of nanoparticles. Adapted from “Decellularization and Recellularization of Whole Organs”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 7

Showcase of the effect of nanomaterial in cell regeneration with Wnt signaling to enhance the therapeutic efficacy of cardiomyocytes with iPSCs. Nanomaterial scaffolds can be used to culture the desired tissues needed for repair in an organ and promote angiogenesis. Adapted from “Nanoparticle Signaling During Cardiomyocyte Differentiation”, by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.

Fig. 8

Central Illustration.