title: Bioinjection treatment: effects of post-injection residual stress on left ventricular wall stress.
abstract: Injection of biomaterials into diseased myocardium has been associated with decreased myofiber stress, restored left ventricular (LV) geometry and improved LV function. However, its exact mechanism(s) of action remained unclear. In this work, we present the first patient-specific computational model of biomaterial injection that accounts for the possibility of residual strain and stress introduced by this treatment. We show that the presence of residual stress can create more heterogeneous regional myofiber stress and strain fields. Our simulation results show that the treatment generates low stress and stretch areas between injection sites, and high stress and stretch areas between the injections and both the endocardium and epicardium. Globally, these local changes are translated into an increase in average myofiber stress and its standard deviation (from 6.9 ± 4.6 to 11.2 ± 48.8 kPa and 30 ± 15 to 35.1 ± 50.9 kPa at end-diastole and end-systole, respectively). We also show that the myofiber stress field is sensitive to the void-to-size ratio. For a constant void size, the myofiber stress field became less heterogeneous with decreasing injection volume. These results suggest that the residual stress and strain possibly generated by biomaterial injection treatment can have large effects on the regional myocardial stress and strain fields, which may be important in the remodeling process.
authors: Department of Mechanical Engineering, Michigan State University, MI, USA. Electronic address: lclee@egr.msu.edu.
authors: Lik Chuan
authors: LC
authors: Lee
authors: Simula Research Laboratory, Oslo, Norway.
authors: Samuel T
authors: ST
authors: Wall
authors: Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Marie-Curie International Outgoing Fellow, Brussels, Belgium.
authors: Martin
authors: M
authors: Genet
authors: Lonestar Heart Inc, Oslo, Norway.
authors: Andy
authors: A
authors: Hinson
authors: Department of Surgery, University of California, San Francisco, CA, USA; Department of Bioengineering, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA.
authors: Julius M
authors: JM
authors: Guccione
mesh_terms: D001672:Biocompatible Materials / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D020342:Finite Element Analysis; D006333:Heart Failure / Q000188:drug therapy / Q000473:pathology; D006352:Heart Ventricles / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D007267:Injections; D009206:Myocardium / Q000473:pathology; D009929:Organ Size / Q000187:drug effects; D066230:Patient-Specific Modeling; D013314:Stress, Mechanical
chemical_list: D001672:Biocompatible Materials
keywords: Biomaterial injection; Congestive heart failure; Left ventricular wall stress; Magnetic resonance imaging; Mathematical modeling