A Computational Study of the Injection Therapy for Myocardial Infarction During the Necrotic Stage

Abstract eng:
Myocardial infarction is an increasing health problem worldwide. Due to an undersupply of blood, the cardiomyocytes in the affected region permanently lose their ability to contract. This in turn gradually weakens the overall heart function. A new therapeutic approach based on the injection of a gel into the infarcted area aims to support the healing and to inhibit adverse re-modelling that can lead to heart failure. A computational model is the basis for obtaining a better understanding of the heart mechanics, in particular, how myocardial infarction and gel injections affect its pumping performance. A strain invariant based stored energy function is proposed to account for the passive mechanical behaviour. The active contraction is represented by the Guccione model [1]. To incorporate injections an additive homogenization approach is introduced. The injectate has been characterized mechanically by indentation tests. As a numerical framework we are using the in-house code SESKA which is based on the Element-Free Galerkin method. The main focus of this contribution is to principally investigate how gel injections influence the mechanics and performance of the left ventricle during a full heart beat, i.e. in the diastolic filling and the systolic contraction phase. This investigation shows, that gel injections are able to reduce maximal fibre stresses caused by an infarct. This

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