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Titel:

A homogenized constrained mixture model of cardiac growth and remodeling: Analyzing mechanobiological stability and reversal

Dokumenttyp:
Zeitschriftenaufsatz
Autor(en):
Amadeus M. Gebauer, Martin R. Pfaller, Fabian A. Braeu, Christian J. Cyron, Wolfgang A. Wall
Abstract:
Cardiac growth and remodeling (G&R) patterns change ventricular size, shape, and function both globally and locally. Biomechanical, neurohormonal, and genetic stimuli drive these patterns through changes in myocyte dimension and fibrosis. We propose a novel microstructure-motivated model that predicts organ-scale G&R in the heart based on the homogenized constrained mixture theory. Previous models, based on the kinematic growth theory, reproduced consequences of G&R in bulk myocardial tissue by prescribing the direction and extent of growth but neglected underlying cellular mechanisms. In our model, the direction and extent of G&R emerge naturally from intra- and extracellular turnover processes in myocardial tissue constituents and their preferred homeostatic stretch state. We additionally propose a method to obtain a mechanobiologically equilibrated reference configuration. We test our model on an idealized 3D left ventricular geometry and demonstrate that our model aims to maintain tensional homeostasis in hypertension conditions. In a stability map, we identify regions of stable and unstable G&R from an identical parameter set with varying systolic pressures and growth factors. Furthermore, we show the extent of G&R reversal after returning the systolic pressure to baseline following stage 1 and 2 hypertension. A realistic model of organ-scale cardiac G&R has the potential to identify patients at risk of heart failure, enable personalized cardiac therapies, and facilitate the optimal design of medical devices.
Stichworte:
Cardiac growth and remodeling, Homogenized constrained mixture model, Computational modeling, Mechanobiology, Hypertension
Zeitschriftentitel:
Biomechanics and Modeling in Mechanobiology
Jahr:
2023
Reviewed:
ja
Sprache:
en
Volltext / DOI:
doi:10.1007/s10237-023-01747-w
Status:
Verlagsversion / published
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