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Simulation of Mitral Valve Plasticity in Response to Myocardial Infarction
Bruno V Rego1, Amir H Khalighi1, Joseph H Gorman2
1James T. Willerson Center for Cardiovascular Modeling and Simulation, Oden Institute for Computational Engineering and Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.
Annals of Biomedical Engineering
|August 27, 2022
Summary
Myocardial infarction (MI) causes ischemic mitral regurgitation (IMR), altering mitral valve (MV) geometry. This study models MV plasticity post-MI, revealing passive tissue deformation is key in the first 8 weeks.
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Computational Biology
Background:
- Left ventricular myocardial infarction (MI) significantly impairs cardiac function, often leading to ischemic mitral regurgitation (IMR).
- IMR results from mitral valve (MV) geometric and functional changes, contributing to high mortality rates.
- Current treatments for IMR are limited due to an incomplete understanding of post-MI MV remodeling.
Purpose of the Study:
- To develop the first computational model of post-MI mitral valve remodeling, termed "mitral valve plasticity."
- To investigate the passive mechanical response of MV tissues during the initial 8 weeks following MI.
Main Methods:
- Constructed a representative geometric model of a pre-MI mitral valve.
- Integrated in vivo ovine MV function, patient-specific modeling, and post-MI adaptation insights.
- Performed finite element simulations of the MV apparatus with time-dependent boundary conditions and altered material properties.
Main Results:
- Post-MI MV remodeling can be accurately modeled using a soft tissue plasticity approach.
- MV tissues undergo significant permanent inelastic deformations in the first 8 weeks post-MI.
- These deformations are primarily a passive response to altered loading conditions, not an independent pathological process.
Conclusions:
- Mitral valve plasticity is a key mechanism in early post-MI adaptation.
- Computational modeling provides a framework for understanding MV response to MI.
- This approach may inform future therapeutic strategies for IMR.
