Mendiola Emilio A, Sacks Michael S, Avazmohammadi Reza
Computational Cardiovascular Bioengineering Laboratory, Department of Biomedical Engineering, Texas A&M University, College Station, TX, United States.
James T. Willerson Center for Cardiovascular Modeling and Simulation, Oden Institute for Computational Engineering and Sciences, Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, United States.
Front Physiol. 2022 May 2;13:878861. doi: 10.3389/fphys.2022.878861. eCollection 2022.
The pericardium is a thin connective tissue membrane that surrounds the heart and is an integral regulatory component of cardiopulmonary performance. Pathological growth and remodeling of the right ventricle (RV) stemming from structural heart diseases are thought to include a significant role of the pericardium, but its exact role remains unclear. The objective of this study was to investigate potential biomechanical adaptations of the pericardium in response to pulmonary hypertension and their effects on heart behavior. Integrated computational-experimental modeling of the heart offers a robust platform to achieve this objective. We built upon our recently developed high-fidelity finite-element models of healthy and hypertensive rodent hearts via addition of the pericardial sac. In-silico experiments were performed to investigate changes in pericardium reserve elasticity and their effects on cardiac function in hypertensive hearts. Our results suggest that contractile forces would need to increase in the RV and decrease in the left ventricle (LV) in the hypertensive heart to compensate for reductions in pericardium reserve elasticity. The discrepancies between chamber responses to pericardium addition result, in part, from differences in the impact of pericardium on the RV and LV preload. We further demonstrated the capability of our platform to predict the effect of pericardiectomy on heart function. Consistent with previous results, the effect of pericardiectomy on the chamber pressure-volume loop was the largest in the hypertensive RV. These insights are expected to motivate further computational investigations of the effect of pericardiectomy on cardiac function which remains an important factor in surgical planning of constrictive pericarditis and coronary artery bypass grafting.
心包是一层薄的结缔组织膜，包裹着心脏，是心肺功能不可或缺的调节组成部分。源于结构性心脏病的右心室（RV）的病理性生长和重塑被认为心包起着重要作用，但其确切作用仍不清楚。本研究的目的是调查心包在肺动脉高压情况下潜在的生物力学适应性及其对心脏行为的影响。心脏的综合计算 - 实验建模为实现这一目标提供了一个强大的平台。我们在最近开发的健康和高血压啮齿动物心脏的高保真有限元模型基础上，添加了心包囊。进行了计算机模拟实验，以研究高血压心脏中心包储备弹性的变化及其对心脏功能的影响。我们的结果表明，高血压心脏中右心室的收缩力需要增加，左心室（LV）的收缩力需要降低，以补偿心包储备弹性的降低。心室对添加心包的反应差异部分源于心包对右心室和左心室前负荷影响的不同。我们进一步证明了我们的平台预测心包切除术对心脏功能影响的能力。与先前的结果一致，心包切除术对高血压右心室的心室压力 - 容积环的影响最大。这些见解有望推动对心包切除术对心脏功能影响的进一步计算研究，而这仍然是缩窄性心包炎和冠状动脉旁路移植手术规划中的一个重要因素。
