Multi-material Cardiac Sleeves with Variable Stiffness Enhance Regional Strain Markers

The regional kinematics of the myocardium are substantially altered post-myocardial infarction (MI). Physical support of the myocardium in the form of a cardiac sleeve has been introduced as a means to improve cardiac function and prevent adverse remodeling in the left ventricle (LV). This study focuses on the impact of multi-material cardiac sleeves with variable stiffness on regional myocardial mechanics following MI. Through in-silico modeling, this work evaluates the ability of tailored cardiac sleeves to modulate global volumetric makers, such as stroke volume and ejection fraction, as well as their influence on regional strain and stress distributions. The analysis highlights the role of material property gradients within the sleeve structure. While changes in global functional markers were modest, the sleeves showed sizable changes in regional myofiber strains, underscoring the potential for regionally targeted mechanical support to improve the remodeling processes in infarcted LV. The findings suggest that while passive sleeves may have a modest impact on overall cardiac function immediately post-implantation, their design can be crucial for optimizing regional biomechanical behavior and preventing a cascade of maladaptive chronic remodeling events. Our findings warrant further studies to explore the potential mitigation of adverse remodeling in MI through the use of spatially tailored passive support sleeves.