Presentation

Abstract
Cardiovascular diseases (CVD) are the leading cause of death globally. Furthermore, minority communities have the highest mortality rate. Myocardial ischemia, a major reason for CVD, results in decreased blood supply and oxygen to the heart, significantly altering metabolism, ion homeostasis, inflammatory response, and redox balance leading to cardiac remodeling. Cardiac remodeling is defined as the changes in the size, geometry, and function of the heart; for this reason, it is important to investigate novel treatments to improve CVD mortality and morbidity. The aims of this study, Evaluating Bioengineered Stem-Cell Derived Extracellular Vesicles in The Treatment of Cardiovascular Diseases, are to evaluate the emergence of bioengineered stem-cell-derived extracellular vesicles (EVs) in treating experimental models of chronic myocardial ischemia, and to explore cardiac remodeling pathology and propose new molecules for bioengineering. A literature review was conducted to evaluate such EVs in experimental models of cardiovascular disease; the following criteria were used – mesenchymal stem cell (MSC) source, bioengineered EV, animal model of myocardial infarction/ischemia. Various studies were evaluated with miRNA overexpression – miR-126, miRNA-18a, miR-93-5p, miR-19a – all with improved therapeutic outcomes. Similarly, protein overexpression of CXCR4, GATA4, Akt, and TIMP2 resulted in cardioprotection. Lastly, CHP and IMTP conjugation to exosomes improved EV targeting to myocardial tissue. EVs are a promising therapeutic approach in treating CVD, and bioengineering presents a unique opportunity to customize contents and improve delivery. Future EV-based treatments can target cardiac remodeling in a variety of manners such as by upregulating glycolysis, inhibiting calcium handling, blocking toll-like receptors, and increasing antioxidants.