Cardiac mechanics modeling: recent developments and current challenges

Patient-specific computational models of the heart are powerful tools for cardiovascular research and medicine, with demonstrated applications in treatment planning, device evaluation, and surgical decision-making. Yet constructing such models is inherently difficult, reflecting the extraordinary complexity of the heart itself. Numerous considerations are required, including reconstructing the anatomy from medical images, representing myocardial mesostructure, capturing material behavior, defining model geometry and boundary conditions, coupling multiple physics, and selecting numerical methods. Many of these choices involve a tradeoff between physiological fidelity and modeling complexity. In this review, we summarize recent advances and unresolved questions in each of these areas, with particular emphasis on cardiac tissue mechanics. We argue that clarifying which complexities are essential, and which can be safely simplified, will be key to enabling clinical translation of these models.