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Myocardial Infarction and Heart Failure

Principal Investigator: Tom Franz

Cardiovascular diseases (CVD) will become the leading cause of death by 2020 superseding infectious diseases such as HIV, TB, and Malaria. The risk of CVD has been reported to increase with the improvement of economic wealth and social environment, in particular in Africa. A higher risk for acute myocardial infarction, the leading causes of Congestive Heart Failure, has been reported in the black African group in Sub-Saharan Africa due to an increased level of hypertension. Similarly, the American Heart Association expects in the near future a dramatic increase in CVD incidences in Africa, in particular in the younger population, in conjunction with the emergence of a new epidemic of obesity, diabetes and uncontrolled hypertension. In 2005, 80.7 million adults had one or more types of cardiovascular disease in the USA alone, 10% of whom were recuperating from a myocardial infarction. Up to one third of infarct patients develop heart failure making myocardial infarct the most common cause of heart failure. The fact that 30-40% of patients die from heart failure within the first year after diagnosis, even with optimal modern treatment, indicates the urgent need for alternative therapies.

            

Early-stage infarct in inferior wall     Scarred infarct with wall thinning


Computational Biomechanics of Myocardial Infarction and Novel Therapies

J Kortsmit, MS Sirry, R Miller, F Masithulela, P Wise, N Davies, T Franz

The aim of this research project is to study the biomechanics of myocardial infarction (MI) and emerging MI therapies based on bio-material injection into the infarct. The biomechanical mechanisms of MI and the efficacy of these new therapies are not well understood. The presented problem is highly complex, including the representation of the architecture of cardiac soft tissue with dispersed biomaterial at micro scale and the highly non-linear elastic myocardial mechanics of the myocardial muscle.

Finite element models of left ventricles showing the distribution of mid-wall myofibre stress at end of systole in a healthy heart (left), heart with ischemic infarct (middle) and heart with scarred infarct and dilated left ventricle (right). (The wire frame depicts the contours of the biventricular cardiac geometry and a frontal view of the antero-apical region of the heart is given.)