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The ECM as a driver of heart development and repair

ABSTRACT The developing heart is formed of two tissue layers separated by an extracellular matrix (ECM) that provides chemical and physical signals to cardiac cells. While deposition of specific ECM components creates matrix diversity, the cardiac ECM is also dynamic, with modification and degradation playing important roles in ECM maturation and function. In this Review, we discuss the spatiotemporal changes in ECM composition during cardiac development that support distinct aspects of heart morphogenesis. We highlight conserved requirements for specific ECM components in human cardiac development, and discuss emerging evidence of a central role for the ECM in promoting heart regeneration. Summary: Cardiac development encompasses the formation and complex morphogenesis of a linear tube. This Review explores how cardiac extracellular matrix composition changes to support specific processes during heart morphogenesis.