Abstract
Adverse ventricular remodelling following acute myocardial infarction (MI) may induce ventricular dilation, fibrosis and loss of global contractile function, possibly resulting in heart failure. Cardiac patches, composed of living cardiac tissue, may be able to restore cardiac function and reduce adverse ventricular remodelling post-MI. The design of these devices is complex and computational modelling may provide means to create an efficient design from a mechanical point of view. In this study, we used a finite element approach to analyze the effect of a cardiac patch, mounted over a chronic infarct region, on left ventricular pump function and myocardial tissue function.
The infarct, 15% in size, was found to reduce stroke work by 30% compared to the healthy heart. This disproportional loss was attributed to unfavourable mechanical interactions in healthy tissue, adjacent to the infarction. The effect of the patch was investigated for a circumferential, an oblique, and a longitudinal orientation. In its most favourable oblique configuration, the cardiac patch was able to recover 6% of stroke work lost. This specific configuration was found to best restore the transmission of active force, that was lost due to the myocardial infarction.
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References
Mechanic, O.J., Gavin, M., Grossman, S.A.: Acute myocardial infarction. In: StatPearls. StatPearls Publishing (2022)
Gupta, K.B., Ratcliffe, M.B., Fallert, M.A., Edmunds, L.H., Jr., Bogen, D.K.: Changes in passive mechanical stiffness of myocardial tissue with aneurysm formation. Circulation 89(5), 2315–2326 (1994). https://doi.org/10.1161/01.CIR.89.5.2315
McGarvey, J.R., Mojsejenko, D., Dorsey, S.M., Nikou, A., Burdick, J.A., Gorman, J.H., et al.: Temporal changes in infarct material properties: an in vivo assessment using magnetic resonance imaging and finite element simulations. Ann. Thorac. Surg. 100(2), 582–589 (2015). https://doi.org/10.1016/j.athoracsur.2015.03.015
Fomovsky, G.M., Macadangdang, J.R., Ailawadi, G., Holmes, J.W.: Model-based design of mechanical therapies for myocardial infarction. J. Cardiovasc. Transl. Res. 4(1), 82–91 (2010). https://doi.org/10.1007/s12265-010-9241-3
Burchfield, J.S., **e, M., Hill, J.A.: Pathological ventricular remodeling: mechanisms: part 1 of 2. Circulation 128(4), 388–400 (2013). https://doi.org/10.1161/CIRCULATIONAHA.113.001878
Frantz, S., Hundertmark, M.J., Schulz-Menger, J., Bengel, F.M., Bauersachs, J.: Left ventricular remodelling postmyocardial infarction: pathophysiology, imaging, and novel therapies. Eur. Heart J. 43(27), 2549–2561 (2022). https://doi.org/10.1093/eurheartj/ehac223
French, B.A., Kramer, C.M.: Mechanisms of post-infarct left ventricular remodeling. Drug Discov. Today Dis. Mech. 4(3), 185–196 (2007). https://doi.org/10.1016/j.ddmec.2007.12.006
Dunlay, S.M., Strand, J.J., Wordingham, S.E., Stulak, J.M., Luckhardt, A.J., Swetz, K.M.: Dying with a left ventricular assist device as destination therapy. Circ. Heart Fail. 9(10), e003096 (2016). https://doi.org/10.1161/CIRCHEARTFAILURE.116.003096
Gao, L., et al.: Large cardiac muscle patches engineered from human induced-pluripotent stem cell-derived cardiac cells improve recovery from myocardial infarction in swine. Circulation 137(16), 1712–1730 (2018). https://doi.org/10.1161/CIRCULATIONAHA.117.030785
Wendel, J.S., Ye, L., Zhang, P., Tranquillo, R.T., Zhang, J.: Functional consequences of a tissue-engineered myocardial patch for cardiac repair in a rat infarct model. Tissue Eng. Part A 20(7–8), 1325–1335 (2014). https://doi.org/10.1089/ten.tea.2013.0312
Kawamura, M., et al.: Feasibility, safety, and therapeutic efficacy of human induced pluripotent stem cell-derived cardiomyocyte sheets in a porcine ischemic cardiomyopathy model. Circulation 126(11 Suppl 1), S29–S37. https://doi.org/10.1161/CIRCULATIONAHA.111.084343
Montgomery, M., Ahadian, S., Davenport Huyer, L. et al.: Flexible shape-memory scaffold for minimally invasive delivery of functional tissues. Nat. Mater. 16, 1038–1046 (2017). https://doi.org/10.1038/nmat4956
Riegler, J., et al.: Human engineered heart muscles engraft and survive long term in a rodent myocardial infarction model. Circ. Res. 117(8), 720–30 (2015). https://doi.org/10.1161/CIRCRESAHA.115.306985
von Bibra, C., et al.: Human engineered heart tissue transplantation in a guinea pig chronic injury model. J. Mol. Cell. Cardiol. 166, 1–10 (2022). https://doi.org/10.1016/j.yjmcc.2022.01.007
Yu, J.K.: Assessment of arrhythmia mechanism and burden of the infarcted ventricles following remuscularization with pluripotent stem cell-derived cardiomyocyte patches using patient-derived models. Cardiovasc. Res. 118(5), 1247–1261 (2022). https://doi.org/10.1093/cvr/cvab140
Janssens, K.L.P.M., Kraamer, M., Barbarotta, L., Bovendeerd, P.H.M.: Post-infarct evolution of ventricular and myocardial function. [manuscript submitted for publication]
Bovendeerd, P.H.M., Kroon, W., Delhaas, T.: Determinants of left ventricular shear strain. Am. J. Physiol. Heart Circ. Physiol. 297(3), H1058–H1068 (2009). https://doi.org/10.1152/ajpheart.01334.2008
Logg, A., Mardal, K.-A., Wells, G.N.: Automated Solution of Differential Equations by the Finite Element Method. The FEniCS Book, vol. 84. Springer, Heidelberg (2012). https://doi.org/10.1007/978-3-642-23099-8
Richardson, W.J., Clarke, S.A., Quinn, T.A., Holmes, J.W.: Physiological implications of myocardial scar structure. Compr. Physiol. 5(4), 1877–909 (2015). https://doi.org/10.1002/cphy.c140067
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This research was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research innovation programme under grant agreement no. 874827 
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Janssens, K.L.P.M., Knaap, M.v.d., Bovendeerd, P.H.M. (2023). Pump and Tissue Function in the Infarcted Heart Supported by a Regenerative Assist Device: A Computational Study. In: Bernard, O., Clarysse, P., Duchateau, N., Ohayon, J., Viallon, M. (eds) Functional Imaging and Modeling of the Heart. FIMH 2023. Lecture Notes in Computer Science, vol 13958. Springer, Cham. https://doi.org/10.1007/978-3-031-35302-4_61
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