The role of regional myocardial topography post‐myocardial infarction on infarct extension

Leong, Chen Onn; Leong, Chin Neng; Liew, Yih Miin; Abed, Amr Al; Aziz, Yang Faridah Abdul; Chee, Kok Han; Sridhar, Ganiga Srinivasaiah; Dokos, Socrates; Lim, Einly

doi:10.1002/cnm.3501

Cited by 3 publications

(2 citation statements)

References 70 publications

(182 reference statements)

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“…Similar discrepancies are observed when comparing our results with those of a more recent study by this group, that employs patient-specific geometries (Leong et al. 2021 ). Possibly these discrepancies are related to the choice of the fiber orientation field.…”

Section: Discussionsupporting

confidence: 88%

Post-infarct evolution of ventricular and myocardial function

Janssens

Kraamer

Barbarotta

et al. 2023

Biomech Model Mechanobiol

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Adverse ventricular remodeling following acute myocardial infarction (MI) may induce ventricular dilation, fibrosis, and loss of global contractile function, possibly resulting in heart failure (HF). Understanding the relation between the time-dependent changes in material properties of the myocardium and the contractile function of the heart may further our understanding of the development of HF post-MI and guide the development of novel therapies. A finite element model of cardiac mechanics was used to model MI in a thick-walled truncated ellipsoidal geometry. Infarct core and border zone comprised 9.6 and 8.1% of the LV wall volume, respectively. Acute MI was modeled by inhibiting active stress generation. Chronic MI was modeled by the additional effect of infarct material stiffening, wall thinning and fiber reorientation. In acute MI, stroke work decreased by 25%. In the infarct core, fiber stress was reduced but fiber strain was increased, depending on the degree of infarct stiffening. Fiber work density was equal to zero. Healthy tissue adjacent to the infarct showed decreased work density depending on the degree of infarct stiffness and the orientation of the myofibers with respect to the infarct region. Thinning of the wall partially restored this loss in work density while the effects of fiber reorientation were minimal. We found that the relative loss in pump function in the infarcted heart exceeds the relative loss in healthy myocardial tissue due to impaired mechanical function in healthy tissue adjacent to the infarct. Infarct stiffening, wall thinning and fiber reorientation did not affect pump function but did affect the distribution of work density in tissue adjacent to the infarct.

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Section: Discussionsupporting

confidence: 88%

Post-infarct evolution of ventricular and myocardial function

Janssens

Kraamer

Barbarotta

et al. 2023

Biomech Model Mechanobiol

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show abstract

“…In addition, infarct-induced changes in maximum stress were much larger than those in our study. Similar discrepancies are observed when comparing our results with those of a more recent study by this group, that employs patient-specific geometries (Leong et al, 2021). Possibly these discrepancies are related to the choice of the fiber orientation field.…”

Section: Literature Comparisonsupporting

confidence: 82%

Post-Infarct Evolution of Ventricular and Myocardial Function

Janssens

Kraamer

Barbarotta

et al. 2023

Preprint

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Introduction Adverse ventricular remodeling following acute myocardial infarction (MI) may induce ventricular dilation, fibrosis, and loss of global contractile function, possibly resulting in heart failure (HF). Understanding the relation between the time-dependent changes in material properties of the myocardium and the contractile function of the heart may further our understanding of the development of HF post-MI and guide the development of novel therapies. Methods A finite element model of cardiac mechanics was used to model MI in a thick-walled truncated ellipsoidal geometry. Infarct core and border zone comprised 9.6\% and 8.1\% of the LV wall volume, respectively. Acute and chronic MI were modeled by reducing active stress generation and subsequent step-wise increase of material stiffness. Results In acute MI, stroke work decreased by 25\%. In the infarct core, fiber stress was reduced but fiber strain was increased, depending on the degree of infarct stiffening. Fiber work density was equal to zero. Healthy tissue adjacent to the infarct showed decreased work density depending on the degree of infarct stiffness and the orientation of the myofibers with respect to the infarct region. Conclusion We found that the relative loss in pump function in the infarcted heart exceeds the relative loss in healthy myocardial tissue due to impaired mechanical function in healthy tissue adjacent to the infarct. Infarct stiffening did not affect pump function but did affect the distribution of work density in tissue adjacent to the infarct.

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