Structure and mechanics of healing myocardial infarcts.
Therapies for myocardial infarction have historically been developed by trial and error, rather than from an understanding of the structure and function of the healing infarct. With exciting new bioengineering therapies for myocardial infarction on the horizon, we have reviewed the time course of structural and mechanical changes in the healing infarct in an attempt to identify key structural determinants of mechanics at several stages of healing. Based on temporal correlation, we hypothesize that normal passive material properties dominate the mechanics during acute ischemia, edema during the subsequent necrotic phase, large collagen fiber structure during the fibrotic phase, and cross-linking of collagen during the long-term remodeling phase. We hope these hypotheses will stimulate further research on infarct mechanics, particularly studies that integrate material testing, in vivo mechanics, and quantitative structural analysis.
Holmes
Jeffrey W
JW
Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA. jh553@columbia.edu
Borg
Thomas K
TK
Covell
James W
JW
D000818:Animals; D001698:Biomedical Engineering / Q000379:methods*; D003094:Collagen / Q000737:chemistry; D004487:Edema; D005355:Fibrosis; D006801:Humans; D007511:Ischemia; D009132:Muscles; D009203:Myocardial Infarction / Q000378:metabolism / Q000473:pathology*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D012756:Sheep; D013997:Time Factors; D020257:Ventricular Remodeling; D014945:Wound Healing
D003094:Collagen