Sharifi Hossein, Mann Charles K, Rockward Alexus L, Mehri Mohammad, Mojumder Joy, Lee Lik-Chuan, Campbell Kenneth S, Wenk Jonathan F
Department of Mechanical Engineering, University of Kentucky, 269 Ralph G. Anderson Building, Lexington, KY 40506-0503 USA.
Department of Mechanical Engineering, Michigan State University, East Lansing, MI USA.
Biophys Rev. 2021 Aug 25;13(5):729-746. doi: 10.1007/s12551-021-00826-5. eCollection 2021 Oct.
Cardiomyocytes can adapt their size, shape, and orientation in response to altered biomechanical or biochemical stimuli. The process by which the heart undergoes structural changes-affecting both geometry and material properties-in response to altered ventricular loading, altered hormonal levels, or mutant sarcomeric proteins is broadly known as cardiac growth and remodeling (G&R). Although it is likely that cardiac G&R initially occurs as an adaptive response of the heart to the underlying stimuli, prolonged pathological changes can lead to increased risk of atrial fibrillation, heart failure, and sudden death. During the past few decades, computational models have been extensively used to investigate the mechanisms of cardiac G&R, as a complement to experimental measurements. These models have provided an opportunity to quantitatively study the relationships between the underlying stimuli (primarily mechanical) and the adverse outcomes of cardiac G&R, i.e., alterations in ventricular size and function. State-of-the-art computational models have shown promise in predicting the progression of cardiac G&R. However, there are still limitations that need to be addressed in future works to advance the field. In this review, we first outline the current state of computational models of cardiac growth and myofiber remodeling. Then, we discuss the potential limitations of current models of cardiac G&R that need to be addressed before they can be utilized in clinical care. Finally, we briefly discuss the next feasible steps and future directions that could advance the field of cardiac G&R.
心肌细胞能够根据改变的生物力学或生化刺激来调整其大小、形状和方向。心脏因心室负荷改变、激素水平改变或肌节蛋白突变而经历影响几何形状和材料特性的结构变化的过程，被广泛称为心脏生长和重塑（G&R）。尽管心脏G&R最初可能是心脏对潜在刺激的适应性反应，但长期的病理变化会导致心房颤动、心力衰竭和猝死风险增加。在过去几十年中，计算模型作为实验测量的补充，已被广泛用于研究心脏G&R的机制。这些模型为定量研究潜在刺激（主要是机械刺激）与心脏G&R的不良后果（即心室大小和功能的改变）之间的关系提供了机会。最先进的计算模型在预测心脏G&R的进展方面已显示出前景。然而，仍存在一些局限性，需要在未来的工作中加以解决，以推动该领域的发展。在这篇综述中，我们首先概述心脏生长和肌纤维重塑计算模型的当前状态。然后，我们讨论当前心脏G&R模型在应用于临床护理之前需要解决的潜在局限性。最后，我们简要讨论可以推动心脏G&R领域发展的下一个可行步骤和未来方向。
