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Excessive volume of hydrogel injectates may compromise the efficacy for the treatment of acute myocardial infarction
Author(s) -
Wise Peter,
Davies Neil H.,
Sirry Mazin S.,
Kortsmit Jeroen,
Dubuis Laura,
Chai ChenKet,
Baaijens Frank P.T.,
Franz Thomas
Publication year - 2016
Publication title -
international journal for numerical methods in biomedical engineering
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.741
H-Index - 63
eISSN - 2040-7947
pISSN - 2040-7939
DOI - 10.1002/cnm.2772
Subject(s) - myocardial infarction , ventricle , cardiology , medicine , ejection fraction , infarction , heart failure , end systolic volume , stroke volume , biomedical engineering
Summary Biomaterial injectates are promising as a therapy for myocardial infarction to inhibit the adverse ventricular remodeling. The current study explored interrelated effects of injectate volume and infarct size on treatment efficacy. A finite element model of a rat heart was utilized to represent ischemic infarcts of 10%, 20%, and 38% of left ventricular wall volume and polyethylene glycol hydrogel injectates of 25%, 50%, and 75% of the infarct volume. Ejection fraction was 49.7% in the healthy left ventricle and 44.9%, 46.4%, 47.4%, and 47.3% in the untreated 10% infarct and treated with 25%, 50%, and 75% injectate, respectively. Maximum end‐systolic infarct fiber stress was 41.6, 53.4, 44.7, 44.0, and 45.3 kPa in the healthy heart, the untreated 10% infarct, and when treated with the three injectate volumes, respectively. Treating the 10% and 38% infarcts with the 25% injectate volume reduced the maximum end‐systolic fiber stress by 16.3% and 34.7% and the associated strain by 30.2% and 9.8%, respectively. The results indicate the existence of a threshold for injectate volume above which efficacy does not further increase but may decrease. The efficacy of an injectate in reducing infarct stress and strain changes with infarct size. Copyright © 2016 John Wiley & Sons, Ltd.