Abstract:

Cardiac fibrosis represents a common and pivotal pathological process in various cardiovascular diseases, significantly impeding cardiac functional recovery and adversely affecting long-term prognosis. Although conventional pharmacological agents, such as renin-angiotensin-aldosterone system inhibitors, exhibit certain anti-fibrotic effects, their insufficient targeting specificity and relatively confined mechanisms of action limit their capacity to achieve precise intervention in the core signaling pathways of cardiac fibrosis. In recent years, nanomaterials have demonstrated considerable potential in the precision treatment and tissue repair of cardiac fibrosis, owing to their unique size effects, tunable surface properties, and favorable biocompatibility. This review summarizes recent advances in nanomaterial-based approaches for cardiac fibrosis repair, with a focus on key strategies including precision delivery, intelligent controlled release, biomimetic functionality, and multifunctional integration. It further elucidates how nanomaterials modulate key signaling pathways at the molecular level and regulate the functions of critical cells, such as fibroblasts, immune cells, and endothelial cells, at the cellular level, thereby facilitating structural reconstruction and functional recovery at the tissue level, and ultimately achieving systematic repair from precision intervention to tissue remodeling. This article also discusses the current status and challenges associated with the clinical translation of nanomaterials in cardiovascular diseases, addressing issues such as biosafety, scalable production, and cross-species translation, and outlines future research directions. This review aims to provide a theoretical foundation and practical guidance for the development of effective and safe nano-therapeutic strategies against cardiac fibrosis.

Key words: cardiac fibrosis, nanomaterials, drug delivery, precision therapy, tissue remodeling