Excessive volume of hydrogel injectates may compromise the efficacy for the treatment of acute myocardial infarction

Int J Numer Method Biomed Eng. 2016 Dec;32(12). doi: 10.1002/cnm.2772. Epub 2016 Apr 8.

Abstract

Biomaterial injectates are promising as a therapy for myocardial infarction to inhibit the adverse ventricular remodeling. The current study explored interrelated effects of injectate volume and infarct size on treatment efficacy. A finite element model of a rat heart was utilized to represent ischemic infarcts of 10%, 20%, and 38% of left ventricular wall volume and polyethylene glycol hydrogel injectates of 25%, 50%, and 75% of the infarct volume. Ejection fraction was 49.7% in the healthy left ventricle and 44.9%, 46.4%, 47.4%, and 47.3% in the untreated 10% infarct and treated with 25%, 50%, and 75% injectate, respectively. Maximum end-systolic infarct fiber stress was 41.6, 53.4, 44.7, 44.0, and 45.3 kPa in the healthy heart, the untreated 10% infarct, and when treated with the three injectate volumes, respectively. Treating the 10% and 38% infarcts with the 25% injectate volume reduced the maximum end-systolic fiber stress by 16.3% and 34.7% and the associated strain by 30.2% and 9.8%, respectively. The results indicate the existence of a threshold for injectate volume above which efficacy does not further increase but may decrease. The efficacy of an injectate in reducing infarct stress and strain changes with infarct size. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: biomaterial; cardiac function; finite element method; indentation tests; polyethylene glycol; ventricular remodeling.

MeSH terms

  • Animals
  • Biocompatible Materials / pharmacology
  • Blood Pressure
  • Finite Element Analysis
  • Heart Ventricles / drug effects*
  • Hemodynamics
  • Hydrogel, Polyethylene Glycol Dimethacrylate / pharmacology*
  • Models, Cardiovascular*
  • Myocardial Infarction / pathology*
  • Polyethylene Glycols / pharmacology
  • Rats
  • Ventricular Remodeling / drug effects*

Substances

  • Biocompatible Materials
  • Hydrogel, Polyethylene Glycol Dimethacrylate
  • Polyethylene Glycols