An Image-Driven Micromechanical Approach to Characterize Multiscale Remodeling in Infarcted Myocardium

Authors

Emilio A Mendiola
Sunder Neelakantan
Qian Xiang
Shuda Xia
Jianyi Zhang
Vahid Serpooshan
Peter Vanderslice
Reza Avazmohammadi

Language

English

Publication Date

1-1-2024

Journal

Acta Biomaterialia

DOI

10.1016/j.actbio.2023.10.027

PMID

37925122

PMCID

PMC10924194

PubMedCentral® Posted Date

3-9-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Myocardial infarction (MI) is accompanied by the formation of a fibrotic scar in the left ventricle (LV) and initiates significant alterations in the architecture and constituents of the LV free wall (LVFW). Previous studies have shown that LV adaptation is highly individual, indicating that the identification of remodeling mechanisms post-MI demands a fully subject-specific approach that can integrate a host of structural alterations at the fiber-level to changes in bulk biomechanical adaptation at the tissue-level. We present an image-driven micromechanical approach to characterize remodeling, assimilating new biaxial mechanical data, histological studies, and digital image correlation data within an in-silico framework to elucidate the fiber-level remodeling mechanisms that drive tissue-level adaptation for each subject. We found that a progressively diffused collagen fiber structure combined with similarly disorganized myofiber architecture in the healthy region leads to the loss of LVFW anisotropy post-MI, offering an important tissue-level hallmark for LV maladaptation. In contrast, our results suggest that reductions in collagen undulation are an adaptive mechanism competing against LVFW thinning. Additionally, we show that the inclusion of subject-specific geometry when modeling myocardial tissue is essential for accurate prediction of tissue kinematics. Our approach serves as an essential step toward identifying fiber-level remodeling indices that govern the transition of MI to systolic heart failure. These indices complement the traditional, organ-level measures of LV anatomy and function that often fall short of early prognostication of heart failure in MI. In addition, our approach offers an integrated methodology to advance the design of personalized interventions, such as hydrogel injection, to reinforce and suppress native adaptive and maladaptive mechanisms, respectively, to prevent the transition of MI to heart failure.

Keywords

Humans, Ventricular Remodeling, Myocardium, Myocardial Infarction, Heart Failure, Collagen, Myocardial infarction, In-silico modeling, Multiscale remodeling, Cardiac strains, Scar maturation

Published Open-Access

yes

Recommended Citation

Mendiola, Emilio A; Neelakantan, Sunder; Xiang, Qian; et al., "An Image-Driven Micromechanical Approach to Characterize Multiscale Remodeling in Infarcted Myocardium" (2024). Faculty, Staff and Student Publications. 6503.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6503