Document Detail


Growth and remodeling of the left ventricle: A case study of myocardial infarction and surgical ventricular restoration.
MedLine Citation:
PMID:  22778489     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Cardiac growth and remodeling in the form of chamber dilation and wall thinning are typical hallmarks of infarct-induced heart failure. Over time, the infarct region stiffens, the remaining muscle takes over function, and the chamber weakens and dilates. Current therapies seek to attenuate these effects by removing the infarct region or by providing structural support to the ventricular wall. However, the underlying mechanisms of these therapies are unclear, and the results remain suboptimal. Here we show that myocardial infarction induces pronounced regional and transmural variations in cardiac form. We introduce a mechanistic growth model capable of predicting structural alterations in response to mechanical overload. Under a uniform loading, this model predicts non-uniform growth. Using this model, we simulate growth in a patient-specific left ventricle. We compare two cases, growth in an infarcted heart, pre-operative, and growth in the same heart, after the infarct was surgically excluded, post-operative. Our results suggest that removing the infarct and creating a left ventricle with homogeneous mechanical properties does not necessarily reduce the driving forces for growth and remodeling. These preliminary findings agree conceptually with clinical observations.
Authors:
Doron Klepach; Lik Chuan Lee; Jonathan F Wenk; Mark B Ratcliffe; Tarek I Zohdi; Jose A Navia; Ghassan S Kassab; Ellen Kuhl; Julius M Guccione
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-12
Journal Detail:
Title:  Mechanics research communications     Volume:  42     ISSN:  1873-3972     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101513597     Medline TA:  Mech Res Commun     Country:  -    
Other Details:
Languages:  ENG     Pagination:  134-141     Citation Subset:  -    
Affiliation:
Department of Surgery, Division of Adult Cardiothoracic Surgery, UC San Francisco, San Francisco, CA 94121, USA.
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