Advancements in finite element modeling of myocardial infarction: a review

Myocardial infarction (MI) remains one of the leading causes of mortality worldwide, with significant long-term consequences on cardiac structure and function. Over the past decades, computational modeling techniques have advanced substantially, providing powerful tools to improve the understanding, diagnosis, and treatment of MI. Among these techniques, the finite element method (FEM) has emerged as a framework for investigating the complex biomechanical, electrophysiological, and structural alterations that occur following infarction. This review provides an overview of the diverse applications of FEM in myocardial infarction research across multiple interconnected areas. Initially, image-based geometric reconstruction and kinematic analysis of the left ventricle are discussed which enable patient-specific modeling. Then, electrophysiological and electromechanical simulations are addressed that capture infarct-induced alterations in electrical conduction and mechanical contraction. The estimation of myocardial material properties, including passive and active constitutive behavior, is reviewed as a critical component for accurate model prediction. Furthermore, growth and remodeling models are analyzed to highlight how infarct progression and ventricular adaptation can be computationally characterized. The role of FEM in studying ischemic and functional mitral regurgitation is also presented, emphasizing valve-ventricle interaction. Finally, FEM-based treatment strategies, including surgical, device-based, and biomaterial interventions, have been reviewed. This review provides a comprehensive overview of current FEM applications in myocardial infarction and highlights key challenges and future research directions for advancing translational and patient-specific cardiac mechanics.