ArticleMolecular & cellular biomechanics : MCB2019
Intramyocardial Injections to De-Stiffen the Heart: A Subject-Specific in Silico Approach.
Article in Molecular & cellular biomechanics : MCB, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Bayesian optimisation for efficient parameter inference in a cardiac mechanics model of the left ventricle.International journal for numerical methods in biomedical engineering · 2022Article
- Personalization of biomechanical simulations of the left ventricle by in-vivo cardiac DTI data: Impact of fiber interpolation methods.Frontiers in physiology · 2022Article
- Establishing the Biofidelity of a Multiphysics Finite Element Model of the Human Heart.Cardiovascular engineering and technology · 2021Article
- Application of feed forward and recurrent neural networks in simulation of left ventricular mechanics.Scientific reports · 2020Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
We hypothesized that minimally invasive injections of a softening agent at strategic locations in stiff myocardium could de-stiffen the left ventricle (LV) globally. Physics-based finite element models of the LV were created from LV echocardiography images and pressures recorded during experiments in four swine. Results confirmed animal models of LV softening by systemic agents. Regional de-stiffening of myocardium led to global de-stiffening of LV. The mathematical set up was used to design LV global de-stiffening by regional softening of myocardium. At an end diastolic pressure of 23 mmHg, when 8 ml of the free wall was covered by intramyocardial injections, end diastolic volume (EDV) increased by 15.0%, whereas an increase up to 11 ml due to intramyocardial injections in the septum and free wall led to a 26.0% increase in EDV. Although the endocardial intramyocardial injections occupied a lower LV wall volume, they led to an EDV (44 ml) that was equal compared to intramyocardial injections in the mid-wall (44 ml) and larger compared to intramyocardial injections in the epicardium (41 ml). Using an in silico set up, sites of regional myocardium de-stiffening could be planned in order to globally soften overly stiff LV in heart failure with preserved ejection fraction. This novel treatment is built on subject-specific data. Hypothesis-testing of these simulation findings in animal models is warranted.
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Registered trials
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