A. Dasi i Martinez. Consideration of electromechanical remodelling during heart failure in a 3D in-silico model of dilated cardiomyopathy. Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT). Masterarbeit. 2020
Dilated cardiomyopathy is a cardiac abnormality affecting millions of people worldwide which complications are due to the several modifications that occur in the structure and function of the heart. The numerous aspects that have to be considered make this disease extremely hard to deal with, especially from an in-vivo or even in-vitro examination. In that context, computational cardiology has become a crucial aspect of modern medicine, enabling the understanding of complex pathologies and favoring the scientific breakthrough. In this light, and in order to gain insight into dilated cardiomyopathy, a detailed computational model of a failing heart is presented in this work. Both, electrophysiology and mechanics were considered in a three-dimensional model of the whole heart, in which diverse features, such as structural modifications, fiber reorganization, cellular alterations and other variables characteristic of the disease, were adopted and assessed. The results obtained from analysing these variables individually and combined show that cellular alterations, especially those affecting the electrophysiology, are mainly responsible for the poor function of the heart in dilated cardiomyopathy, whereas multi-scale changes, such as fiber reorganization and cellular uncoupling, have little effect on the mechanical behaviour. The structural remodeling and modifications in the passive properties and circulatory system are key aspects to take into account, which together with the cellular remodeling constitute the features that need to be included in a computational model of dilated cardiomyopathy.