Keawepono Wong
BME PhD Proposal Presentation

Date:2022-03-10
Time: 10:00 AM
Location / Meeting Link: https://emory.zoom.us/j/8201949924

Committee Members:
Muralidhar Padala, PhD (Advisor) Brandon Dixon, PhD Amir Pourmorteza, PhD Sung Jin Park, PhD Robert Guyton, MD


Title: Optimization of ventricular reshaping to maximize reverse remodeling in a model of ischemic cardiomyopathy

Abstract: Heart failure (HF) is a prevalent disease that affects 6.7 million people in the United States. Though the underlying etiologies that cause HF are several, HF secondary to myocardial infarction (MI) or ischemia is the most common. In this condition, complete loss, or sustained lower perfusion to some of the myocardium, initiates functional deterioration and a series of structural changes in the ventricular chamber. Ventricular thinning and dilatation are the two prominent structural features, which are a result of the initial insult, but also cause further worsening of HF. The geometric phenotype of the failing heart elevates ventricular wall stresses, the passive diastolic stretch on the cardiomyocyte, and the cardiac fiber orientation is in a disarray that inhibits translation of a ~15% cardiomyocyte twitch into a 60% chamber ejection fraction. In a recent pre-clinical study, our lab demonstrated that reshaping the heart in an early-stage heart failure model, with an implantable device can improve cardiac function. In this thesis, I propose to build upon this work as follows: - (aim 1) characterize the left ventricular remodeling after a myocardial infarction in the rat, delineating the functional, geometric, wall structural, and ultrastructural changes in the myocardium, (aim 2) using an implantable ventricular reshaping device, investigate the acute effects of different configurations of reshaping on improvement in chamber function; (aim 3) investigate the chronic effects of the most optimal ventricular reshaping strategy, and evaluate its ability to induce reverse remodeling; and (aim 4) design and prototype a transcatheter device to reshape the beating heart in a human.