A review of healing myocardial infarcts hypothesizes that passive material properties, edema, collagen structure, and cross-linking dominate mechanics at successive stages of healing.
This review proposes hypotheses linking the structural determinants of healing myocardial infarcts to their mechanical properties across different stages of healing to guide future bioengineering therapies.
Therapies for myocardial infarction have historically been developed by trial and error, rather than from an understanding of the structure and function of the healing infarct. With exciting new bioengineering therapies for myocardial infarction on the horizon, we have reviewed the time course of structural and mechanical changes in the healing infarct in an attempt to identify key structural determinants of mechanics at several stages of healing. Based on temporal correlation, we hypothesize that normal passive material properties dominate the mechanics during acute ischemia, edema during the subsequent necrotic phase, large collagen fiber structure during the fibrotic phase, and cross-linking of collagen during the long-term remodeling phase. We hope these hypotheses will stimulate further research on infarct mechanics, particularly studies that integrate material testing, in vivo mechanics, and quantitative structural analysis.
Holmes et al. (2005) conducted a review in Myocardial infarction. A review of healing myocardial infarcts hypothesizes that passive material properties, edema, collagen structure, and cross-linking dominate mechanics at successive stages of healing.