This work was supported by grants from the German Federal Ministry for Economic Affairs and Climate Action (ZIM) and from the German Federal Ministry of Education and Research (KMUinnovativ). We thank FUJIFILM Cellular Dynamics, Inc (Madison, WI, USA) for kindly providing cardiomyocytes and Ncardia B.V. (Leiden, The Netherlands) for kindly providing cardiomyocytes, used in this study.

NOTE: The workflow for contractility and impedance/EFP measurement is given in Supplementary Figure 2.
1. Plate coating
<ol>
	<li>Open the vacuum-sealed packaging and take out the 96-well plate. Handling procedures for 96-well plates of both modules are the same. Leave the contraction plate covered by the additionally supplied membrane guard until measurement in the contractility module.</li>
	<li>Coat the flexible 96-well plates for seeding cardiomyocytes.
	<ol>
		<li>Prepare a diluted EHS gel coating solution by transferring 2.75 mL of EHS gel ready-to-use solution in a sterile centrifuge tube. Then add 8.25 mL of DPBS with Ca2+ and Mg2+. Mix the solution carefully. 
		NOTE: Optionally, fibronectin can also be used for coating the wells: prepare 13 mL of fibronectin coating solution in a sterile centrifuge tube by diluting 650 &#181;L of fibronectin stock solution (1 &#181;g/mL) in 13 mL of DPBS with Ca2+ and Mg2+, resulting in a 50 &#181;g/mL working solution. Mix the solution carefully.</li>
	</ol>
	</li>
	<li>Transfer the coating solution into a sterile reagent reservoir placed in the lab automation robot.</li>
	<li>Add 100 &#181;L of the coating solution per well with the lab automation robot by using the program &#34;ADD100&#181;L&#34;. Place the lid back onto the 96-well plate and incubate for 3 h at 37 &#730;C. 
	&#8203;NOTE: The program for the lab automation robot needs to be preset manually beforehand.</li>
</ol>
2. Seeding of human iPSC-derived cardiomyocytes into flexible 96-well plates (Day 0)
<ol>
	<li>Thaw the cells according to manufacturer&#39;s guidelines.</li>
	<li>Count the cells with a manual counting chamber and adjust the cells in the recommended plating medium according to the cell manufacturer instructions (e.g., 1 x 105 cells/well), resulting in 11 x 106 cells/11 mL for seeding an entire 96-well plate.</li>
	<li>Remove the EHS gel solution from the wells with the lab automation robot using the program &#34;REMOVE100&#181;L&#34;. Remove the reagent reservoir containing the dispensed coating solution from the robot.</li>
	<li>Transfer the cell suspension (11 mL total) into a sterile reagent reservoir placed in the lab automation robot and seed the cells with 100 &#181;L/well using the program &#34;CELLS_ADD100&#181;L&#34;.</li>
	<li>Immediately after cell seeding, transfer the flexible 96-well plate into the incubator (37 &#730;C, 5% CO2, humidity-controlled) and let the cells settle overnight.</li>
</ol>
3. Medium exchange of flexible 96-well plates (Day 1)
<ol>
	<li>Warm at least 22 mL of cardiomyocyte maintenance medium per plate to 37 &#730;C in a 50 mL centrifuge tube, 18-24 h after seeding the plates.</li>
	<li>Transfer the fresh medium (at least 22 mL) into a sterile reagent reservoir and leave it right next to the lab automation robot. Place an empty reagent reservoir in the robot and perform medium removal with the program &#34;REMOVE100&#181;L&#34;. Afterward, exchange the reagent reservoir containing the waste medium with the reagent reservoir containing the fresh medium and dispense 200 &#181;L of the fresh medium per well with the program &#34;ADD100&#181;L&#34;. Perform this step twice to reach 200 &#181;L/well.</li>
	<li>Immediately after medium exchange, transfer the plate back into the incubator.</li>
	<li>Perform a medium exchange (200 &#181;L/well) every other day until compound addition.</li>
</ol>
4. Final medium exchange before compound addition (Day 5-7)
<ol>
	<li>Perform a final medium change 4-6 h before compound addition.</li>
	<li>Warm at least 22 mL of assay buffer for one flexible 96-well plate. The assay buffer consists of maintenance medium or derivatives thereof (e.g., low/no serum media, phenol red free media, or other isotonic buffers).</li>
	<li>Transfer the fresh medium into a sterile reagent reservoir and leave it right next to the lab automation robot. Place an empty reagent reservoir in the robot and perform medium removal. Afterward, exchange the reagent reservoir containing the waste medium with the reagent reservoir containing the fresh medium and dispense 200 &#181;L/well of the fresh medium.</li>
	<li>Immediately after medium exchange, transfer the flexible plate back into the incubator.</li>
</ol>
5. Compound addition and data recording (Day 5-7)
NOTE: An example measurement plan for the experiment is given in Supplementary Figure 3.
<ol>
	<li>Prepare working solution per compound at 4x concentration in the laminar flow hood using a sterile regular 96-deep well plate. The compound solution is based on the assay buffer used in step 4. Transfer the 96-deep well plate containing the compound solution for at least 1 h into the incubator to adjust it to the same condition as the flexible plate. 
	NOTE: The 1x concentration of each drug used for every experiment is provided in the figures and legends.</li>
	<li>Transfer the plate to the respective measurement device 1 h before performing a baseline measurement.</li>
	<li>Open Edit Protocol in the control software (part of the hybrid cell analysis system) and select the respective measurement mode contractility or impedance/EFP.</li>
	<li>Define the sweep duration (length of one measurement; e.g., 30 s) and the repetition interval (time between measurements; e.g., 5 min) and save the protocol number.</li>
	<li>Select Start protocol &#62; Continue and fill in the requested fields.</li>
	<li>Finally, select Start measurement. Perform a minimum of three baseline measurements (sweeps) in 5 min intervals shortly before compound addition. 
	NOTE: Example data of a contractility baseline measurement using the contractility module before compound addition is depicted in Supplementary Figure 4</li>
	<li>Remove 50 &#181;L of the assay buffer from each well without removing the flexible 96-well plate from the measurement device.</li>
	<li>Add 50 &#181;L of the 4x concentrated compound solution into each well of the plate, according to the measurement plan.</li>
	<li>Select Add region marker and define the compound plate layout and the volume of the compound solution after compound addition.</li>
	<li>Finally, select Proceed with standard measurement or Proceed with measurement series according to the experimental plan.</li>
</ol>
6. Data analysis
<ol>
	<li>With recording software, measure sweeps, whose length and repetition interval are defined by the user.</li>
	<li>With analysis software, capture the shape of the signal by reading out parameters like amplitude, beat rate, pulse width, and so forth, automatically. 
	NOTE: An averaged signal including the standard deviation, the so-called mean beat, is automatically calculated based on the data of one sweep. The user can define the contractility/IMP/EFP parameters that the software calculates and display.</li>
	<li>With analysis software calculate the dose-response curve and IC50/EC50 for each compound. 
	NOTE: The raw data and the analysis results generated with the analysis software can be easily exported in a variety of formats. Finally, the data reports are automatically generated to summarize and archive the experimental results. A comprehensive description of what and how an EFP signal is measured is discussed in 17.</li>
</ol>

<ol>
	<li>Weaver, R. J., Valentin, J. -. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Today's+challenges+to+de-risk+and+predict+drug+safety+in+human+&amp;#34;mind-the-gap&amp;#34.">Today's challenges to de-risk and predict drug safety in human &amp;#34;mind-the-gap&amp;#34.</a> Toxicological Sciences. 167 (2), 307-321 (2019).</li><li>Burnett, S. D., Blanchette, A. D., Chiu, W. A., Rusyn, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+induced+pluripotent+stem+cell+(iPSC)-derived+cardiomyocytes+as+an+in+vitro+model+in+toxicology:+strengths+and+weaknesses+for+hazard+identification+and+risk+characterization.">Human induced pluripotent stem cell (iPSC)-derived cardiomyocytes as an in vitro model in toxicology: strengths and weaknesses for hazard identification and risk characterization.</a> Expert Opinion on Drug Metabolism Toxicology. 17 (8), 887-902 (2021).</li><li>Gintant, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Repolarization+studies+using+human+stem+cell-derived+cardiomyocytes:+Validation+studies+and+best+practice+recommendations.">Repolarization studies using human stem cell-derived cardiomyocytes: Validation studies and best practice recommendations.</a> Regulatory Toxicology and Pharmacology. 117, 104756 (2020).</li><li>Pang, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Toxicity+testing+in+the+era+of+induced+pluripotent+stem+cells:+A+perspective+regarding+the+use+of+patient-specific+induced+pluripotent+stem+cell-derived+cardiomyocytes+for+cardiac+safety+evaluation.">Toxicity testing in the era of induced pluripotent stem cells: A perspective regarding the use of patient-specific induced pluripotent stem cell-derived cardiomyocytes for cardiac safety evaluation.</a> Current Opinion in Toxicology. 23, 50-55 (2020).</li><li>Ahmed, R. E., Anzai, T., Chanthra, N., Uosaki, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+brief+review+of+current+maturation+methods+for+human+induced+pluripotent+stem+cells-derived+cardiomyocytes.">A brief review of current maturation methods for human induced pluripotent stem cells-derived cardiomyocytes.</a> Frontiers in Cell and Developmental Biology. 8, 178 (2020).</li><li>Gossmann, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Integration+of+mechanical+conditioning+into+a+high+throughput+contractility+assay+for+cardiac+safety+assessment.">Integration of mechanical conditioning into a high throughput contractility assay for cardiac safety assessment.</a> Journal of Pharmacological and Toxicological Methods. 105, 106892 (2020).</li><li>Hansen, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+drug+screening+platform+based+on+engineered+heart+tissue.">Development of a drug screening platform based on engineered heart tissue.</a> New Methods in Cardiovascular Biology. 107 (1), 35-44 (2010).</li><li>Zuppinger, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=3D+Cardiac+cell+culture:+a+critical+review+of+current+technologies+and+applications.">3D Cardiac cell culture: a critical review of current technologies and applications.</a> Frontiers in Cardiovascular Medicine. 6, 87 (2019).</li><li>Laverty, H. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+can+we+improve+our+understanding+of+cardiovascular+safety+liabilities+to+develop+safer+medicines.">How can we improve our understanding of cardiovascular safety liabilities to develop safer medicines.</a> British Journal of Pharmacology. 163 (4), 675-693 (2011).</li><li>Volkova, M., Russel, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anthracycline+cardiotoxicity:+prevalence,+pathogenesis+and+treatment.">Anthracycline cardiotoxicity: prevalence, pathogenesis and treatment.</a> Current Cardiology Reviews. 7 (4), 214-220 (2011).</li><li>Bozza, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anthracycline-induced+cardiotoxicity:+molecular+insights+obtained+from+human-induced+pluripotent+stem+cell-derived+cardiomyocytes+(hiPSC-CMs).">Anthracycline-induced cardiotoxicity: molecular insights obtained from human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs).</a> The AAPS Journal. 23 (2), (2021).</li><li>Sutherland, F. J., Hearse, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+isolated+blood+and+perfusion+fluid+perfused+heart.">The isolated blood and perfusion fluid perfused heart.</a> Pharmacological Research. 41 (6), 613-627 (2000).</li><li>Brown, G. E., Khetani, S. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Microfabrication+of+liver+and+heart+tissues+for+drug+development.">Microfabrication of liver and heart tissues for drug development.</a> Philosophical Transactions of the Royal Society B: Biological Sciences. 373 (1750), 20170225 (2018).</li><li>Scott, C. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+impedance-based+cellular+assay+using+human+iPSC-derived+cardiomyocytes+to+quantify+modulators+of+cardiac+contractility.">An impedance-based cellular assay using human iPSC-derived cardiomyocytes to quantify modulators of cardiac contractility.</a> Toxicological Sciences. 142 (2), 313-338 (2014).</li><li>Gossmann, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechano-pharmacological+characterization+of+cardiomyocytes+derived+from+human+induced+pluripotent+stem+cells.">Mechano-pharmacological characterization of cardiomyocytes derived from human induced pluripotent stem cells.</a> Cellular Physiology and Biochemistry. 38 (3), 1182-1198 (2016).</li><li>Rappaz, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Automated+multi-parameter+measurement+of+cardiomyocytes+dynamics+with+digital+holographic+microscopy.">Automated multi-parameter measurement of cardiomyocytes dynamics with digital holographic microscopy.</a> Optics Express. 23 (10), 13333-13347 (2015).</li><li>Doerr, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=New+easy-to-use+hybrid+system+for+extracellular+potential+and+impedance+recordings.">New easy-to-use hybrid system for extracellular potential and impedance recordings.</a> Journal of Laboratory Automation. 20 (2), 175-188 (2014).</li><li>Obergrussberger, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+pharmacology+studies+using+EFP+and+impedance.">Safety pharmacology studies using EFP and impedance.</a> Journal of Pharmacological and Toxicological Methods. 81, 223-232 (2016).</li><li>Bot, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cross-site+comparison+of+excitation-contraction+coupling+using+impedance+and+field+potential+recordings+in+hiPSC+cardiomyocytes.">Cross-site comparison of excitation-contraction coupling using impedance and field potential recordings in hiPSC cardiomyocytes.</a> Journal of Pharmacological and Toxicological Methods. 93, 46-58 (2018).</li><li>Pang, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Workshop+report:+FDA+workshop+on+improving+cardiotoxicity+assessment+with+human-relevant+platforms.">Workshop report: FDA workshop on improving cardiotoxicity assessment with human-relevant platforms.</a> Circulation Research. 125 (9), 855-867 (2019).</li><li>Edwards, S. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+multiwell+cardiac+&#181;GMEA+platform+for+action+potential+recordings+from+human+iPSC-derived+cardiomyocyte+constructs.">A multiwell cardiac &#181;GMEA platform for action potential recordings from human iPSC-derived cardiomyocyte constructs.</a> Stem Cell Reports. 11 (2), 522-536 (2018).</li><li>Zlochiver, V., Kroboth, S., Beal, C. R., Cook, J. A., Joshi-Mukherjee, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=R.Human+iPSC-derived+cardiomyocyte+networks+on+multiwell+micro-electrode+arrays+for+recurrent+action+potential+recordings.">R.Human iPSC-derived cardiomyocyte networks on multiwell micro-electrode arrays for recurrent action potential recordings.</a> Journal of Visualized Experiments. (149), e59906 (2019).</li></ol>

B.L., M.Go., and P.L. are employed at innoVitro GmbH, manufacturer of the flexible plates. U.T., E.D., M.L., M.Ge., N.F., and S.S. are employed at Nanion Technologies GmbH, manufacturer of the hybrid device.

The impedance/EFP/contractility hybrid system is a comprehensive methodology for high throughput safety pharmacological and toxicological assessment of cardiac liabilities for preclinical drug development. It provides a modern approach for preclinical safety testing without the use of animal models, but with higher throughput capabilities that significantly reduce time and costs. This system has the potential to be used as a complementary approach for the Langendorff Heart and other animal models for preclinical function...

One of the major goals of modern drug development is the improvement of the bench-to-bedside success rate of new therapeutics in the drug discovery pipeline. Safety pharmacological testing of these new drugs often reveals adverse drug reactions on the cardiovascular system that accounts for almost one-quarter of the drug attrition rate at preclinical stages1. The development and integration of new approach methodologies (NAMs) play a key role in the modernization of preclinical assessment, in particular core battery organs like the heart. Since these methodologies are animal-free approaches, the use of human-based cell models like cardiomyocytes (CMs) of induced pluripotent stem cell (iPSC) origin became the workhorse over the past decade for the modern assessment of safety pharmacological and toxicological issues2. Widely used assay systems for such investigations are microelectrode array (MEA) and voltage-sensitive dye-based experimental approaches3.
Nevertheless, the claimed phenotypic and functional immaturity of this cell type puts obstacles in the way of an ideal human-based cell model, with the potential to reduce translational gaps between non-clinical and clinical studies4.
Tremendous research has been conducted over the years to understand the reason for the implied immature phenotype and to find ways to push the maturation process of human iPSC-CMs in vitro.
Lacking cardiac maturation cues such as prolonged cell culture times, an absence of other cell types in the vicinity, or a lack of hormonal stimulation was shown to affect the maturation process5. Also, the non-physiological environment of regular cell culture plates was identified as a significant cause that impedes the maturation of human iPSC-CMs, due to the missing physiological substrate stiffness of the native human heart5,6.
Different assay systems with a focus on native physiological conditions were developed to tackle this issue, including 3D cell culture systems where cells are aligned three-dimensionally to resemble native cardiac architecture instead of typical two-dimensional cell cultures7. Although improved maturation is obtained with 3D assays, the need for a skilled workforce and the low throughput of these systems hampers an abundant use of this in the drug development process, since time and cost play a fundamental role in the assessment of new therapeutics on a financial level8.
Important readouts for safety pharmacological and toxicological assessment of new therapeutics are changes in functional and structural characteristics of human iPSC-CMs, since compound-induced adverse drug reactions of the cardiovascular system usually affect one or both of these properties1,9. Well-known examples of such broad adverse reactions are anti-cancer drugs of the anthracycline family. Here, hazardous functional and adverse structural effects on the cardiovascular system are widely reported during and after cancer treatment in patients as well as with in vitro cell-based assays10,11.
In the present study, we describe a comprehensive methodology for the assessment of both functional and structural compound side effects on hiPSC-CMs. The methodology includes the analysis of cardiomyocyte contractile force and impedance/Extracellular Field Potential (EFP) analysis. The contractile force is measured under physiological mechanical conditions, with the cells cultured on soft (33 kPa) silicone substrates, reflecting the mechanical environment of native human heart tissue.
The system is equipped with 96-well plates for high throughput analysis of human iPSC-CMs for preclinical cardiac safety pharmacological and toxicological studies, and thus provides an advantage to currently used 3D approaches like Langendorff heart or heart slices12,13.
In detail, the hybrid system consists of two modules, either for the assessment of cardiac contractility under physiological conditions or the analysis of real-time cellular structural toxicity6,14. Both modules work with specialized high throughput 96-well plates for fast and cost-effective data acquisition.
Without the need for a 3D construct, the contractility module employs special plates that contain flexible silicone membranes as the substrate for the cells instead of the stiff glass or plastic that regular cell culture plates usually consist of. The membranes reflect typical human biomechanical heart properties and therefore mimic in vivo conditions in a high throughput manner. While human iPSC-CMs often fail to display adult cardiomyocyte behavior regarding compound-induced positive inotropy in other cell-based assays14, a more adult-like reaction can be assessed when the cells are cultured on the plates of the contractility module. In previous studies, it has been demonstrated that iPSC-CMs exhibit positive inotropic effects upon treatment with compounds such as isoproterenol, S-Bay K8644, or omecamtiv mecarbil6,15. Here, multiple contractility parameters can be assessed, such as primary parameters like the amplitude of contraction force (mN/mm2), beat duration, and beat rate, as well as secondary parameters of the contraction cycle like area under the curve, contraction, and relaxation slopes, beat rate variations, and arrhythmias (Supplementary Figure 1)16. Drug-induced changes in all parameters are assessed non-invasively by capacitive distance sensing. The raw data is analyzed subsequently by specialized software.
The structural toxicity module adds its unique impedance and EFP parameters as a readout for structural cellular toxicity and the analysis of electrophysiological properties17,18. The electrical impedance spectroscopy technology reveals compound-induced changes in cell density or cell and monolayer integrity monitored in real-time, as shown with human iPSC-CMs treated with known cardiotoxic compounds13. With impedance readouts at different frequencies (1-100 kHz) it is possible to dissect a physiological response further, and thus revealing changes in membrane topography, cell-cell, or cell-matrix junctions is achievable. The additional EFP recording of human iPSC-CMs further enables the analysis of electrophysiological effects elicited by compound treatment, as was shown in the light of the CiPA study17,19.
In the present study, human iPSC-CMs were employed, treated with epirubicin and doxorubicin, both well-described as cardiotoxic anthracyclines, and erlotinib, a tyrosine kinase inhibitor (TKI) with a rather low risk of cardiovascular toxicity. Chronic assessment with epirubicin, doxorubicin, and erlotinib was performed for 5 days. The result shows minor changes in contractility and base impedance when cells were treated with erlotinib, but a time and dose-dependent toxic decrease in contraction amplitude and base impedance when treated with epirubicin and doxorubicin respectively. Acute measurements were performed with calcium channel blocker nifedipine and show a decrease in contraction amplitude, field potential duration, and base impedance, demonstrating cardiotoxic side effects of this compound on functional as well as structural levels.

<table><tbody><tr><td>Commercial human iPSC-derived cardiomyocytes&amp;nbsp;</td><td>Fujifilm Cellular Dynamics International (FCDI)</td><td>R1059</td><td></td></tr><tr><td>Centrifuge (50 mL tubes)</td><td>Thermo Fisher Scientific</td><td>15878722</td><td></td></tr><tr><td>12-channel adjustable pipette (100-1250 &amp;mu;L)</td><td>Integra Biosciences</td><td>4634</td><td></td></tr><tr><td>DPBS with Ca2+ and Mg2+</td><td>GE Healthcare HyClone</td><td>SH304264.01</td><td></td></tr><tr><td>96 deep well plate</td><td>Thermo Fisher Scientific</td><td>A43075</td><td></td></tr><tr><td>EHS gel</td><td></td><td></td><td>Extracellular Matrix Gel</td></tr><tr><td>FLEXcyte 96/CardioExcyte hybrid device</td><td>Nanion Technologies&amp;nbsp;</td><td>19 1004 1005</td><td>Hybrid cell analysis system&amp;nbsp;</td></tr><tr><td>FLX-96 FLEXcyte Sensor Plates</td><td>Nanion Technologies</td><td>20 1010</td><td></td></tr><tr><td>&amp;nbsp;Fibronectin stock solution (Optional to Geltrex)</td><td>Sigma Aldrich</td><td>F1141</td><td></td></tr><tr><td>Geltrex hESC-Qualified, Ready-To-Use, Reduced Growth Factor Basement Membrane Matrix</td><td>ThermoFischer Scientific</td><td>A1569601</td><td></td></tr><tr><td>Human iPSC-derived cardiomyocytes plating and maintenance medium</td><td>FCDI</td><td>R1059</td><td></td></tr><tr><td>Incubator (37 &amp;deg;C, 5% CO2)</td><td>Thermo Fisher Scientific</td><td>51023121</td><td></td></tr><tr><td>Laminar Flow Hood</td><td>Thermo Fisher Scientific</td><td>51032678</td><td></td></tr><tr><td>NSP-96 CardioExcyte 96 Sensor Plates 2.0 mm transparent</td><td>Nanion Technologies</td><td>20 1011</td><td></td></tr><tr><td>Pipette tips (1250&amp;micro;L)</td><td>Integra Biosciences</td><td>94420813</td><td></td></tr><tr><td>Reagent Reservoir</td><td>Integra Biosciences</td><td>8096-11</td><td></td></tr><tr><td>Serological pipette (e.g. 25 mL)</td><td>Thermo Fisher Scientific</td><td>16440901</td><td></td></tr><tr><td>Single channel adjustable pipette (e.g. 100-1000 &amp;mu;L)</td><td>Eppendorf</td><td>3123000063</td><td></td></tr><tr><td>Vacuum aspiration system</td><td>Thermo Fisher Scientific</td><td>15567479</td><td></td></tr><tr><td>Optional: VIAFLO ASSIST</td><td>Integra Biosciences</td><td>4500</td><td>Lab automation Robot</td></tr><tr><td>Water bath (37 &amp;deg;C)</td><td>Thermo Fisher Scientific</td><td>15365877</td><td></td></tr></tbody></table>

hybrid cell analysis system to assess structural and contractile changes of human ipsc-derived cardiomyocytes for preclinical cardiac risk evaluation

Cardiac contractility assessment is of immense importance for the development of new therapeutics and their safe transition into clinical stages. While human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) hold promise to serve as a human-relevant model in preclinical phases of drug discovery and safety pharmacology, their maturity is still controversial in the scientific community and under constant development. We present a hybrid contractility and impedance/extracellular field potential (EFP) technology, adding significant pro-maturation features to an industry-standard 96-well platform.
The impedance/EFP system monitors cellular functionality in real-time. Besides the beat rate of contractile cells, the electrical impedance spectroscopy readouts detect compound-induced morphological changes like cell density and integrity of the cellular monolayer. In the other component of the hybrid cell analysis system, the cells are cultured on bio-compliant membranes that mimic the mechanical environment of real heart tissue. This physiological environment supports the maturation of hiPSC-CMs in vitro, leading to more adult-like contractile responses including positive inotropic effects after treatment with isoproterenol, S-Bay K8644, or omecamtiv mecarbil. Parameters such as the amplitude of contraction force (mN/mm2) and beat duration also reveal downstream effects of compounds with influence on electrophysiological properties and calcium handling.
The hybrid system provides the ideal tool for holistic cell analysis, allowing preclinical cardiac risk assessment beyond the current perspectives of human-relevant cell-based assays.

The effects of kinase inhibitor erlotinib on the contractility of hiPSC-CMs are shown in Figure 1. The cells were treated with concentrations ranging from 10 nM to 10 &#181;M for 5 days and beat parameters were recorded daily. Erlotinib, an EGFR (epidermal growth factor receptor) and tyrosine kinase inhibitor with a comparably low risk of cardiotoxicity, had a minor dose and time-dependent effect on hiPSC-CMs only at concentrations in the micromolar range. At the lowest concentration (10 nM)...

Watch this Scientific Journal Video about Hybrid Cell Analysis System to Assess Structural and Contractile Changes of Human iPSC-Derived Cardiomyocytes for Preclinical Cardiac Risk Evaluation at JoVE.

Hybrid Cell Analysis System to Assess Structural and Contractile Changes of Human iPSC-Derived Cardiomyocytes for Preclinical Cardiac Risk Evaluation

The analysis of changes in contractile function and cellular integrity of human iPSC-derived cardiomyocytes is of immense importance for nonclinical drug development. A hybrid 96-well cell analysis system addresses both parameters in a real-time and physiological manner for reliable, human-relevant results, necessary for a safe transition into clinical stages.

Cardiac contractility assessment is of immense importance for the development of new therapeutics and their safe transition into clinical stages. While ...

hybrid-cell-analysis-system-to-assess-structural-contractile-changes

Research

JoVE Journal

Bioengineering

1.7K Views.  innoVitro GmbH. De methode kan helpen bij het beantwoorden van preklinische cardiale veiligheid en toxiciteit gerelateerde vragen met behulp van echte op mensen gebaseerde gegevens voor een veilige overgang van nieuwe kandidaat-geneesmiddelen naar klinische stadia. In plaats van een reeks verschillende in-vitro- en in-vivotechnieken te gebruiken, is het belangrijkste voordeel van dit hybride systeem de gelijktijdige beoordeling van van menselijke iPC afgeleide cardiomyocyten, elektrofysiologische en levensva...

Video: Hybrid Cell Analysis System to Assess Structural and Contractile Changes of Human iPSC-Derived Cardiomyocytes for Preclinical Cardiac Risk Evaluation

Automated Contraction Analysis of Human Engineered Heart Tissue for Cardiac Drug Safety Screening

Cardiac tissue engineering describes techniques to constitute three dimensional force-generating engineered tissues. For the implementation of these procedures in basic research and preclinical drug development, it is important to develop protocols for automated generation and analysis under standardized conditions. Here, we present a technique to generate engineered heart tissue (EHT) from cardiomyocytes of different species (rat, mouse, human). The technique relies on the assembly of a fibrin-gel containing dissociated cardiomyocytes between elastic polydimethylsiloxane (PDMS) posts in a 24-well format. Three-dimensional, force-generating EHTs constitute within two weeks after casting. This procedure allows for the generation of several hundred EHTs per week and is technically limited only by the availability of cardiomyocytes (0.4-1.0 x 106/EHT). Evaluation of auxotonic muscle contractions is performed in a modified incubation chamber with a mechanical interlock for 24-well plates and a camera placed on top of this chamber. A software controls a camera moved on an XYZ axis system to each EHT. EHT contractions are detected by an automated figure recognition algorithm, and force is calculated based on shortening of the EHT and the elastic propensity and geometry of the PDMS posts. This procedure allows for automated analysis of high numbers of EHT under standardized and sterile conditions. The reliable detection of drug effects on cardiomyocyte contraction is crucial for cardiac drug development and safety pharmacology. We demonstrate, with the example of the hERG channel inhibitor E-4031, that the human EHT system replicates drug responses on contraction kinetics of the human heart, indicating it to be a promising tool for cardiac drug safety screening.

Here, we show the generation of human engineered heart tissue from induced pluripotent stem cells (hiPSC)-derived cardiomyocytes. We present a method to analyze contraction force and exemplary alteration of contraction pattern by the hERG channel inhibitor E-4031. This method shows high level of robustness and suitability for cardiac drug screening.

Cardiac tissue engineering describes techniques to constitute three dimensional force-generating engineered tissues. For the implementation of these ...

Preclinical Cardiac Electrophysiology Assessment by Dual Voltage and Calcium Optical Mapping of Human Organotypic Cardiac Slices

Human cardiac slice preparations have recently been developed as a platform for human physiology studies and therapy testing to bridge the gap between animal and clinical trials. Numerous animal and cell models have been used to examine the effects of drugs, yet these responses often differ in humans. Human cardiac slices offer an advantage for drug testing in that they are directly derived from viable human hearts. In addition to having preserved multicellular structures, cell-cell coupling, and extracellular matrix environments, human cardiac tissue slices can be used to directly test the effect of innumerable drugs on adult human cardiac physiology. What distinguishes this model from other heart preparations, such as whole hearts or wedges, is that slices can be subjected to longer-term culture. As such, cardiac slices allow for studying the acute as well as chronic effects of drugs. Furthermore, the ability to collect several hundred to a thousand slices from a single heart makes this a high-throughput model to test several drugs at varying concentrations and combinations with other drugs at the same time. Slices can be prepared from any given region of the heart. In this protocol, we describe the preparation of left ventricular slices by isolating tissue cubes from the left ventricular free wall and sectioning them into slices using a high precision vibrating microtome. These slices can then either be subjected to acute experiments to measure baseline cardiac electrophysiological function or cultured for chronic drug studies. This protocol also describes dual optical mapping of cardiac slices for simultaneous recordings of transmembrane potentials and intracellular calcium dynamics to determine the effects of the drugs being investigated.

This protocol describes the procedure for sectioning and culturing human cardiac slices for preclinical drug testing and details the use of optical mapping for recording transmembrane voltage and intracellular calcium signals simultaneously from these slices.

Human cardiac slice preparations have recently been developed as a platform for human physiology studies and therapy testing to bridge the gap between ...

Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are currently being explored for multiple in vitro applications and have been used in regulatory submissions. Here, we extend their use to cardiac medical device safety or performance assessments. We developed a novel method to evaluate cardiac medical device contractile properties in robustly contracting 2D hiPSC-CMs monolayers plated on a flexible extracellular matrix (ECM)-based hydrogel substrate. This tool enables the quantification of the effects of cardiac electrophysiology device signals on human cardiac function (e.g., contractile properties) with standard laboratory equipment. The 2D hiPSC-CM monolayers were cultured for 2-4 days on a flexible hydrogel substrate in a 48-well format.
The hiPSC-CMs were exposed to standard cardiac contractility modulation (CCM) medical device electrical signals and compared to control (i.e., pacing only) hiPSC-CMs. The baseline contractile properties of the 2D hiPSC-CMs were quantified by video-based detection analysis based on pixel displacement. The CCM-stimulated 2D hiPSC-CMs plated on the flexible hydrogel substrate displayed significantly enhanced contractile properties relative to baseline (i.e., before CCM stimulation), including an increased peak contraction amplitude and accelerated contraction and relaxation kinetics. Furthermore, the utilization of the flexible hydrogel substrate enables the multiplexing of the video-based cardiac-excitation contraction coupling readouts (i.e., electrophysiology, calcium handling, and contraction) in healthy and diseased hiPSC-CMs. The accurate detection and quantification of the effects of cardiac electrophysiological signals on human cardiac contraction is vital for cardiac medical device development, optimization, and de-risking. This method enables the robust visualization and quantification of the contractile properties of the cardiac syncytium, which should be valuable for nonclinical cardiac medical device safety or effectiveness testing. This paper describes, in detail, the methodology to generate 2D hiPSC-CM hydrogel substrate monolayers.

Here, we demonstrate a non-invasive cardiac medical device contractility evaluation method using 2D human induced pluripotent stem cell-derived cardiomyocyte (hiPSC-CM) monolayers, plated on a flexible substrate, coupled with video-based microscopy. This tool will be useful for the in vitro evaluation of the contractile properties of cardiac electrophysiology devices.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are currently being explored for multiple in vitro applications and have been used ...

High-Throughput Cardiotoxicity Screening Using Mature Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Monolayers

Human induced stem cell-derived cardiomyocytes (hiPSC-CMs) are used to replace and reduce the dependence on animals and animal cells for preclinical cardiotoxicity testing. In two-dimensional monolayer formats, hiPSC-CMs recapitulate the structure and function of the adult human heart muscle cells when cultured on an optimal extracellular matrix (ECM). A human perinatal stem cell-derived ECM (maturation-inducing extracellular matrix-MECM) matures the hiPSC-CM structure, function, and metabolic state in 7 days after plating. 
Mature hiPSC-CM monolayers also respond as expected to clinically relevant medications, with a known risk of causing arrhythmias and cardiotoxicity. The maturation of hiPSC-CM monolayers was an obstacle to the widespread adoption of these valuable cells for regulatory science and safety screening, until now. This article presents validated methods for the plating, maturation, and high-throughput, functional phenotyping of hiPSC-CM electrophysiological and contractile function. These methods apply to commercially available purified cardiomyocytes, as well as stem cell-derived cardiomyocytes generated in-house using highly efficient, chamber-specific differentiation protocols. 
High-throughput electrophysiological function is measured using either voltage-sensitive dyes (VSDs; emission: 488 nm), calcium-sensitive fluorophores (CSFs), or genetically encoded calcium sensors (GCaMP6). A high-throughput optical mapping device is used for optical recordings of each functional parameter, and custom dedicated software is used for electrophysiological data analysis. MECM protocols are applied for medication screening using a positive inotrope (isoprenaline) and human Ether-a-go-go-related gene (hERG) channel-specific blockers. These resources will enable other investigators to successfully utilize mature hiPSC-CMs for high-throughput, preclinical cardiotoxicity screening, cardiac medication efficacy testing, and cardiovascular research.

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) offer an alternative to using animals for preclinical cardiotoxicity screening. A limitation to the widespread adoption of hiPSC-CMs in preclinical toxicity screening is the immature, fetal-like phenotype of the cells. Presented here are protocols for robust and rapid maturation of hiPSC-CMs.

Human induced stem cell-derived cardiomyocytes (hiPSC-CMs) are used to replace and reduce the dependence on animals and animal cells for preclinical ...

Contractions of Human-iPSC-derived Cardiomyocyte Syncytia Measured with a Ca-sensitive Fluorescent Dye in Temperature-controlled 384-well Plates

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac physiology and pharmacology. Various methods have been proposed to record this spontaneous activity and to evaluate drug effects, but many of these methods suffer from limited throughput and/or physiological relevance. We developed a high-throughput screening system to quantify the effects of exogenous compounds on hiPSC-CM's beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader. We describe how to prepare the cell plates and the compound plates and how to run the automated assay to achieve high sensitivity and reproducibility. We also describe how to transform and analyze the fluorescence data to provide reliable measures of drug effects on spontaneous rhythm. This assay can be used in drug discovery programs to guide chemical optimization away from, or toward, compounds affecting human cardiac function.

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells are useful models of human cardiac physiology and pharmacology. Here we present a high-throughput screening system to quantify the effects of exogenous compounds on beating frequency, using a Ca-sensitive fluorescent dye and a temperature-controlled imaging multi-well plate reader.

Spontaneously contracting syncytia of cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM) are a useful model of human cardiac ...

Medicine

Generation of Ventricular-Like HiPSC-Derived Cardiomyocytes and High-Quality Cell Preparations for Calcium Handling Characterization

Human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) provide a valuable human source for studying the basic science of calcium (Ca2+) handling and signaling pathways as well as high-throughput drug screening and toxicity assays. Herein, we provide a detailed description of the methodologies used to generate high-quality iPSC-CMs that can consistently reproduce molecular and functional characteristics across different cell lines. Additionally, a method is described to reliably assess their functional characterization through the evaluation of Ca2+ handling properties. Low oxygen (O2) conditions, lactate selection, and prolonged time in culture produce high-purity and high-quality ventricular-like cardiomyocytes. Similar to isolated adult rat cardiomyocytes (ARCMs), 3-month-old iPSC-CMs exhibit higher Ca2+ amplitude, faster rate of Ca2+ reuptake (decay-tau), and a positive lusitropic response to &#946;-adrenergic stimulation compared to day 30 iPSC-CMs. The strategy is technically simple, cost-effective, and reproducible. It provides a robust platform to model cardiac disease and for the large-scale drug screening to target Ca2+ handling proteins.

Here we describe and validate a method to consistently generate robust human induced pluripotent stem cell-derived cardiomyocytes and characterize their function. These techniques may help in developing mechanistic insight into signaling pathways, provide a platform for large-scale drug screening, and reliably model cardiac diseases.

Human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) provide a valuable human source for studying the basic science of calcium (Ca2+) ...

Model of Ischemic Heart Disease and Video-Based Comparison of Cardiomyocyte Contraction Using hiPSC-Derived Cardiomyocytes

Ischemic heart disease is a significant cause of death worldwide. It has therefore been the subject of a tremendous amount of research, often with small-animal models such as rodents. However, the physiology of the human heart differs significantly from that of the rodent heart, underscoring the need for clinically relevant models to study heart disease. Here, we present a protocol to model ischemic heart disease using cardiomyocytes differentiated from human induced pluripotent stem cells (hiPS-CMs) and to quantify the damage and functional impairment of the ischemic cardiomyocytes. Exposure to 2% oxygen without glucose and serum increases the percentage of injured cells, which is indicated by staining of the nucleus with propidium iodide, and decreases cellular viability. These conditions also decrease the contractility of hiPS-CMs as confirmed by displacement vector field analysis of microscopic video images. This protocol may furthermore provide a convenient method for personalized drug screening by facilitating the use of hiPS cells from individual patients. Therefore, this model of ischemic heart disease, based on iPS-CMs of human origin, can provide a useful platform for drug screening and further research on ischemic heart disease.

We present a model of ischemic heart disease using cardiomyocytes derived from human induced pluripotent stem cells, together with a method for quantitative evaluation of tissue damage caused by ischemia. This model can provide a useful platform for drug screening and further research on ischemic heart disease.

Ischemic heart disease is a significant cause of death worldwide. It has therefore been the subject of a tremendous amount of research, often with ...

High Efficiency Differentiation of Human Pluripotent Stem Cells to Cardiomyocytes and Characterization by Flow Cytometry

There is an urgent need to develop approaches for repairing the damaged heart, discovering new therapeutic drugs that do not have toxic effects on the heart, and improving strategies to accurately model heart disease. The potential of exploiting human induced pluripotent stem cell (hiPSC) technology to generate cardiac muscle &#8220;in a dish&#8221; for these applications continues to generate high enthusiasm. In recent years, the ability to efficiently generate cardiomyogenic cells from human pluripotent stem cells (hPSCs) has greatly improved, offering us new opportunities to model very early stages of human cardiac development not otherwise accessible. In contrast to many previous methods, the cardiomyocyte differentiation protocol described here does not require cell aggregation or the addition of Activin A or BMP4 and robustly generates cultures of cells that are highly positive for cardiac troponin I and T (TNNI3, TNNT2), iroquois-class homeodomain protein IRX-4 (IRX4), myosin regulatory light chain 2, ventricular/cardiac muscle isoform (MLC2v) and myosin regulatory light chain 2, atrial isoform (MLC2a) by day 10 across all human embryonic stem cell (hESC) and hiPSC lines tested to date. Cells can be passaged and maintained for more than 90 days in culture. The strategy is technically simple to implement and cost-effective. Characterization of cardiomyocytes derived from pluripotent cells often includes the analysis of reference markers, both at the mRNA and protein level. For protein analysis, flow cytometry is a powerful analytical tool for assessing quality of cells in culture and determining subpopulation homogeneity. However, technical variation in sample preparation can significantly affect quality of flow cytometry data. Thus, standardization of staining protocols should facilitate comparisons among various differentiation strategies. Accordingly, optimized staining protocols for the analysis of IRX4, MLC2v, MLC2a, TNNI3, and TNNT2 by flow cytometry are described.

The article describes the detailed methodology to efficiently differentiate human pluripotent stem cells into cardiomyocytes by selectively modulating the Wnt pathway, followed by flow cytometry analysis of reference markers to assess homogeneity and identity of the population.

There is an urgent need to develop approaches for repairing the damaged heart, discovering new therapeutic drugs that do not have toxic effects on the ...

Biology

Technical Applications of Microelectrode Array and Patch Clamp Recordings on Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes

Drug-induced cardiotoxicity is the leading cause of drug attrition and withdrawal from the market. Therefore, using appropriate preclinical cardiac safety assessment models is a critical step during drug development. Currently, cardiac safety assessment is still highly dependent on animal studies. However, animal models are plagued by poor translational specificity to humans due to species-specific differences, particularly in terms of cardiac electrophysiological characteristics. Thus, there is an urgent need to develop a reliable, efficient, and human-based model for preclinical cardiac safety assessment. Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have emerged as an invaluable in vitro model for drug-induced cardiotoxicity screening and disease modeling. hiPSC-CMs can be obtained from individuals with diverse genetic backgrounds and various diseased conditions, making them an ideal surrogate to assess drug-induced cardiotoxicity individually. Therefore, methodologies to comprehensively investigate the functional characteristics of hiPSC-CMs need to be established. In this protocol, we detail various functional assays that can be assessed on hiPSC-CMs, including the measurement of contractility, field potential, action potential, and calcium handling. Overall, the incorporation of hiPSC-CMs into preclinical cardiac safety assessment has the potential to revolutionize drug development.

Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have emerged as a promising in vitro model for drug-induced cardiotoxicity screening and disease modeling. Here, we detail a protocol for measuring the contractility and electrophysiology of hiPSC-CMs.

Drug-induced cardiotoxicity is the leading cause of drug attrition and withdrawal from the market. Therefore, using appropriate preclinical cardiac safety ...

Analyzing the &alpha;-Actinin Network in Human iPSC-Derived Cardiomyocytes Using Single Molecule Localization Microscopy

The maturation of iPSC-derived cardiomyocytes is a critical issue for their application in regenerative therapy, drug testing and disease modeling. Despite the development of multiple differentiation protocols, the generation of iPSC cardiomyocytes resembling an adult-like phenotype remains challenging. One major aspect of cardiomyocytes maturation involves the formation of a well-organized sarcomere network to ensure high contraction capacity. Here, we present a super resolution-based approach for semi-quantitative analysis of the &#945;-actinin network in cardiomyocytes. Using photoactivated localization microscopy a comparison of sarcomere length and z-disc thickness of iPSC-derived cardiomyocytes and cardiac cells isolated from neonatal tissue was performed. At the same time, we demonstrate the importance of proper imaging conditions to obtain reliable data. Our results show that this method is suitable to quantitatively monitor the structural maturity of cardiac cells with high spatial resolution, enabling the detection of even subtle changes of sarcomere organization.

Analyzing the &#945;-Actinin Network in Human iPSC-Derived Cardiomyocytes Using Single Molecule Localization Microscopy

The formation of a proper sarcomere network is important for the maturation of iPSC-derived cardiomyocytes. We present a super resolution-based approach that allows for the quantitative evaluation of the structural maturation of stem cell derived cardiomyocytes, to improve culture conditions promoting cardiac development.

The maturation of iPSC-derived cardiomyocytes is a critical issue for their application in regenerative therapy, drug testing and disease modeling. ...

Hybrid Cell Analysis System to Assess Structural and Contractile Changes of Human iPSC-Derived Cardiomyocytes for Preclinical Cardiac Risk Evaluation

Samenvatting

Meer video's verkennen