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Advances in Biomechanics & Applications
  Volume 1, Number 1, March 2014, pages 41-55
open access

Computational predictions of improved of wall mechanics and function of the infarcted left ventricle at early and late remodelling stages: comparison of layered and bulk hydrogel injectates
Jeroen Kortsmit, Neil H. Davies, Renee Miller, Peter Zilla and Thomas Franz

    Acellular intra-myocardial biomaterial injections have been shown to be therapeutically beneficial in inhibiting ventricular remodelling of myocardial infarction (MI). Based on a biventricular canine cardiac geometry, various finite element models were developed that comprised an ischemic (II) or scarred infarct (SDI) in left ventricular (LV) antero-apical region, without and with intra-myocardial biomaterial injectate in layered (L) and bulk (B) distribution. Changes in myocardial properties and LV geometry were implemented corresponding to infarct stage (tissue softening vs. stiffening, infarct thinning, and cavity dilation) and injectate (infarct thickening). The layered and bulk injectate increased ejection fraction of the infarcted LV by 77% (II+L) and 25% (II+B) at the ischemic stage and by 61% (SDI+L) and 63% (SDI+B) at the remodelling stage. The injectates decreased the mean end-systolic myofibre stress in the infarct by 99% (II+L), 97% (II+B), 70% (SDI+L) and 36% (SDI+B). The bulk injectate was slightly more effective in improving LV function at the remodelling stage whereas the layered injectate was superior in functional improvement at ischemic stage and in reduction of wall stress at ischemic and remodelling stage. These findings may stimulate and guide further research towards tailoring acellular biomaterial injectate therapies for MI.
Key Words
    myocardial infarct; therapeutic injection; cardiac remodelling; finite element method
Jeroen Kortsmit, Neil H. Davies, Renee Miller and Peter Zilla: Cardiovascular Research Unit, Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, South Africa
Thomas Franz: Cardiovascular Research Unit, Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, South Africa; Center for Research in Computational and Applied Mechanics, University of Cape Town, Rondebosch, South Africa; Research Office, University of Cape Town, Mowbray, South Africa; Center for High Performance Computing, Rosebank, South Africa

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