Section-level spatial autocorrelation enables cross-study evaluation of myocardial organization after dECM deployment

Decellularized extracellular matrix (dECM) is a tissue-derived scaffold that remains after cellular material is removed. After delivery, it encounters the heterogeneous myocardium, creating a need for a tissue-scale readout that can be applied across formulations and delivery settings. We developed a section-level spatial-autocorrelation readout and applied it to 21 publicly available, analytically separable capture/section units from two rat Visium studies of intramyocardial dECM injection and simulated intracoronary infusion. A histology-based, sample-balanced atlas aligned the broad cardiac fields represented in both studies. For each section, we averaged separately calculated Moran’s I values for cardiomyocyte, fibroblast, myeloid, and endothelial fields and then estimated the association with dECM exposure in a study- and time-stratified model. The dECM coefficient was +0.0832 (95% CI −0.0240 to +0.1903; exact two-sided p = 0.0933). The estimate was positive, while the interval included zero and retained substantial uncertainty in direction and magnitude. All four-field coefficients and all 21 leave-one-unit-out estimates were positive, and the direction persisted after field omission, broader spatial graphs, and the use of a separately constructed field representation. Orthology-corrected spatial ranks identified an overlapping extracellular matrix (ECM)/collagen program family whose fixed-rule scores were spatially structured. The analysis provides a common section-level axis for heterogeneous dECM studies and defines an ECM/collagen hypothesis for prospective experiments that measure material properties and tissue organization together.