Bacterial Nanocellulose Hydrogels as a Next-Generation Biomaterial for Cardiac and Vascular Tissue Engineering: Structural, Biological, and Translational Perspectives.

Since current therapies cannot regenerate lost myocardium or reverse adverse ventricular remodeling-major contributors to worldwide cardiovascular mortality-advanced biomaterials, particularly hydrogels, have emerged as promising therapeutic platforms. Among these, bacterial nanocellulose (BNC) has gained increasing attention due to its hydrated nanofibrillar architecture, high crystallinity, robust mechanical performance, and excellent water-retention capacity, features that closely resemble key aspects of the native extracellular matrix. These properties provide a favorable microenvironment for cell adhesion, survival, and tissue organization in cardiovascular applications. Preclinical evidence suggests that BNC-based cardiac constructs, including acellular patches and cell-laden systems, may reduce post-infarction ventricular dilation, promote angiogenesis, and improve cellular engraftment. In vascular tissue engineering, BNC has also been explored in small-diameter grafts, anisotropic hydrogel systems, and shape-memory conduits with encouraging hemocompatibility and functional durability. Functional modifications-including gelatin incorporation, oxidative surface treatments, peptide grafting, conductive polymers, and structural alignment strategies-further expand the biological and mechanical versatility of BNC-based systems. In addition, BNC-containing bioinks have demonstrated promising rheological behavior, printability, and cell compatibility for 3D bioprinting applications. Despite these advances, important challenges remain, including optimization of material functionalization, host integration, degradation control, vascularization, scalable manufacturing, and regulatory translation toward clinical application.