title: Excessive volume of hydrogel injectates may compromise the efficacy for the treatment of acute myocardial infarction.
abstract: 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.
authors.affiliation: Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Observatory, South Africa.
authors.forename: Peter
authors.initials: P
authors.lastname: Wise
authors.affiliation: Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Observatory, South Africa.
authors.forename: Neil H
authors.initials: NH
authors.lastname: Davies
authors.affiliation: Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Observatory, South Africa.|Department of Biomedical Engineering, University of Medical Sciences and Technology, Khartoum, Sudan.
authors.forename: Mazin S
authors.initials: MS
authors.lastname: Sirry
authors.affiliation: Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Observatory, South Africa.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Kortsmit
authors.affiliation: Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Observatory, South Africa.|Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Observatory, South Africa.
authors.forename: Laura
authors.initials: L
authors.lastname: Dubuis
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Chen-Ket
authors.initials: CK
authors.lastname: Chai
authors.affiliation: Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
authors.forename: Frank P T
authors.initials: FP
authors.lastname: Baaijens
authors.affiliation: Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, Observatory, South Africa.|Research Office, University of Cape Town, Mowbray, South Africa.|Center for High Performance Computing, Rosebank, South Africa.
authors.forename: Thomas
authors.initials: T
authors.lastname: Franz
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology; D001794:Blood Pressure; D020342:Finite Element Analysis; D006352:Heart Ventricles / Q000187:drug effects*; D006439:Hemodynamics; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000494:pharmacology*; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000473:pathology*; D011092:Polyethylene Glycols / Q000494:pharmacology; D051381:Rats; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D001672:Biocompatible Materials; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D011092:Polyethylene Glycols
keywords: biomaterial; cardiac function; finite element method; indentation tests; polyethylene glycol; ventricular remodeling