Hydrogel Cardiac Tissue Integrated with Biosensors for Monitoring Cardiac Dysfunction

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, underscoring the need for advanced in vitro models that closely mimic native cardiac function. Traditional models, such as single-cell cultures and 2D monolayers, fail to replicate the complex mechanoelectrical coupling of human myocardium, limiting insights into disease mechanisms and pharmacological responses. Recent advances in tissue engineering have enabled the fabrication of 3D cardiac constructs that better capture the structural and functional intricacies of the heart. Central to this progress are hydrogel scaffolds, which provide cell-adhesive, biocompatible matrices with tunable mechanics and extracellular matrix-like properties, supporting cell adhesion, proliferation, and differentiation. These constructs are increasingly integrated with biosensing platforms capable of real-time, in situ monitoring of cardiac dynamics. Innovations, such as conductive hydrogel pillars, engineered cardiac patches, and thin-film microelectrode arrays, offer high-resolution, high-throughput interrogation of electrophysiological and mechanical signals while mitigating sensor-tissue impedance mismatches. Here, we review the recent progress in hydrogel-based tissue engineering and biosensing technologies for 3D cardiac models. We highlight key advances, identify persistent challenges, and outline future directions toward synchronized mechanoelectrical monitoring. This integrated strategy offers a powerful framework for elucidating CVD pathophysiology, improving drug screening, and advancing precision cardiovascular medicine.