@misc{gebauer_a_homogenized_2023, 
author={Gebauer, A.M., Pfaller, M.R., Braeu, F.A., Cyron, C.J., Wall, W.A.},
title={A homogenized constrained mixture model of cardiac growth and remodeling: analyzing mechanobiological stability and reversal},
year={2023},
howpublished = {journal article},
doi = {https://doi.org/10.1007/s10237-023-01747-w},
abstract = {Cardiac growth and remodeling (G&R) patterns change ventricular size, shape, and function both globally and locally. Biomechanical, neurohormonal, and genetic stimuli drive these patterns through changes in myocyte dimension and fibrosis. We propose a novel microstructure-motivated model that predicts organ-scale G&R in the heart based on the homogenized constrained mixture theory. Previous models, based on the kinematic growth theory, reproduced consequences of G&R in bulk myocardial tissue by prescribing the direction and extent of growth but neglected underlying cellular mechanisms. In our model, the direction and extent of G&R emerge naturally from intra- and extracellular turnover processes in myocardial tissue constituents and their preferred homeostatic stretch state. We additionally propose a method to obtain a mechanobiologically equilibrated reference configuration. We test our model on an idealized 3D left ventricular geometry and demonstrate that our model aims to maintain tensional homeostasis in hypertension conditions. In a stability map, we identify regions of stable and unstable G&R from an identical parameter set with varying systolic pressures and growth factors. Furthermore, we show the extent of G&R reversal after returning the systolic pressure to baseline following stage 1 and 2 hypertension. A realistic model of organ-scale cardiac G&R has the potential to identify patients at risk of heart failure, enable personalized cardiac therapies, and facilitate the optimal design of medical devices.},
note = {Online available at: \url{https://doi.org/10.1007/s10237-023-01747-w} (DOI). Gebauer, A.; Pfaller, M.; Braeu, F.; Cyron, C.; Wall, W.: A homogenized constrained mixture model of cardiac growth and remodeling: analyzing mechanobiological stability and reversal. Biomechanics and Modeling in Mechanobiology. 2023. vol. 22, 1983-2002. DOI: 10.1007/s10237-023-01747-w}}