Advanced nanomaterials for myocardial ischemia-reperfusion injury: Bridging precision imaging to targeted therapy

Myocardial ischemia-reperfusion injury (MIRI) is a major cause of heart failure, driven by oxidative stress, inflammation, and rapid loss of cardiomyocytes. Traditional therapies for MIRI remain limited, largely due to poor cardiac targeting and an absence of real-time diagnostic capabilities. Recently, various nanomaterials (NMs) have been extensively developed and applied to achieve more precise and effective treatment of MIRI, owing to their favorable biosafety and functional tunability. This review comprehensively summarizes the latest research progress on functional NMs in diagnostic imaging and therapeutic interventions for MIRI. In the context of diagnostic imaging, in vitro nano-biosensors enable the early detection of MIRI biomarkers, while NM-enhanced imaging modalities provide high diagnostic precision at the in vivo level and support real-time therapeutic guidance. Therapeutically, NMs can be leveraged as direct antioxidative agents, vehicles for targeted gene therapy, and platforms for combination regimens including gas therapy, stem cell therapy, and circadian rhythm modulation, to enhance myocardial repair. By synthesizing these advancements, this review provides conceptual and technological insights that could guide the future of nanomedicine-enabled precision cardiovascular care.