Multi-Scale Fiber Remodeling in HCM Using a Stress-Based Fiber Reorientation Law

TL;DR

This paper introduces a multiscale finite element model with a stress-based fiber reorientation law to quantify how different pathological factors like fibrosis and contractility impairments induce fiber disarray in hypertrophic cardiomyopathy, affecting cardiac function.

Contribution

It presents a novel multiscale modeling approach that specifically incorporates a stress-based fiber reorientation law to study fiber disarray in HCM.

Findings

Fibrosis and contractility impairments significantly influence fiber disarray.

The model quantifies the impact of pathological changes on cardiac function.

Heterogeneous impairments contribute differently to disease progression.

Abstract

Quantifying fiber disarray, which is a prominent maladaptation associated with hypertrophic cardiomyopathy, remains critical to understanding the disease's complex pathophysiology. This study investigates the role of heterogeneous impairment of fiber contractility and fibrosis in the induction of disarray and their subsequent impact on cardiac pumping function. Fiber disarray is modeled via a stress-based fiber reorientation law within a multiscale finite element cardiac modeling framework called MyoFE. Using multiscale modeling capabilities, this study quantifies the distinct impacts of hypocontractility, hypercontractility and fibrosis on the development of fiber disarray and quantifies how their contributions affect the functional characteristics of the heart.