A computational model that predicts reverse growth in response to mechanical unloading
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Ventricular growth is widely considered to be an important feature in the adverse progression of heart diseases, whereas reverse ventricular growth (or reverse remodeling) is often considered to be a favorable response to clinical intervention. In recent years, a number of theoretical models have been proposed to model the process of ventricular growth while little has been done to model its reverse. Based on the framework of volumetric strain-driven finite growth with a homeostatic equilibrium range for the elastic myofiber stretch, we propose here a reversible growth model capable of describing both ventricular growth and its reversal. We used this model to construct a semi-analytical solution based on an idealized cylindrical tube model, as well as numerical solutions based on a truncated ellipsoidal model and a human left ventricular model that was reconstructed from magnetic resonance images. We show that our model is able to predict key features in the end-diastolic pressure–volume relationship that were observed experimentally and clinically during ventricular growth and reverse growth. We also show that the residual stress fields generated as a result of differential growth in the cylindrical tube model are similar to those in other nonidentical models utilizing the same geometry.
KeywordsRemodeling Reverse remodeling Growth End-diastolic pressure–volume relationship Finite element method Magnetic resonance imaging
This work was supported by NIH Grants R01-HL-077921 and R01-HL-118627 (J.M. Guccione); K25-NS058573-05 (G. Acevedo-Bolton); NSF Grants 0952021 and 1233054 (E. Kuhl); and Marie Curie international outgoing fellowship within the 7th European Community Framework Program (M. Genet). We thank the reviewers for their valuable comments, which have helped us improve the presentation.
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