Competing mechanisms of stress-assisted diffusivity and stretch-activated currents in cardiac electromechanics

TL;DR

This study explores how mechanical stress influences cardiac tissue conductivity through two mechanisms, stretch-activated currents and stress-assisted diffusion, affecting electrical propagation and arrhythmia dynamics in heart models.

Contribution

It introduces a novel multiphysics model incorporating both MEF mechanisms and compares them with experimental data, advancing understanding of cardiac electromechanics.

Findings

Stress-assisted diffusion explains observed inhomogeneity and anisotropy.

Proper conduction velocity requires specific combinations of MEF effects.

Mechanical loading significantly affects spiral wave behavior.

Abstract

We numerically investigate the role of mechanical stress in modifying the conductivity properties of the cardiac tissue and its impact in computational models for cardiac electromechanics. We follow a theoretical framework recently proposed in [Cherubini, Filippi, Gizzi, Ruiz-Baier, JTB 2017], in the context of general reaction-diffusion-mechanics systems using multiphysics continuum mechanics and finite elasticity. In the present study, the adapted models are compared against preliminary experimental data of pig right ventricle fluorescence optical mapping. These data contribute to the characterization of the observed inhomogeneity and anisotropy properties that result from mechanical deformation. Our novel approach simultaneously incorporates two mechanisms for mechano-electric feedback (MEF): stretch-activated currents (SAC) and stress-assisted diffusion (SAD); and we also identify their influence into the nonlinear spatiotemporal dynamics. It is found that i) only specific combinations of the two MEF effects allow proper conduction velocity measurement; ii) expected heterogeneities and anisotropies are obtained via the novel stress-assisted diffusion mechanisms; iii) spiral wave meandering and drifting is highly mediated by the applied mechanical loading. We provide an analysis of the intrinsic structure of the nonlinear coupling using computational tests, conducted using a finite element method. In particular, we compare static and dynamic deformation regimes in the onset of cardiac arrhythmias and address other potential biomedical applications.