Regional myocardial mechanics: integrative computational models of flow-function relations.

Many cardiac disorders result in regionally altered myocardial mechanics. Although myocardial strain distributions can be measured experimentally and clinically, regional wall stresses must be computed from computational models. Combining these approaches can provide insight into the structural basis of regional dysfunction under conditions such as acute myocardial infarction and ischemia-reperfusion. Recently, 3-dimensional computational models have helped to elucidate the structural basis of the functional border zone adjacent to acutely ischemic myocardium. They have also shown that heterogeneous dysfunction in ischemic-reperfused stunned myocardium does not necessarily imply heterogeneous myofilament injury. Now that computational models are able to reproduce many complex features of the 3-dimensional patterns of regional myocardial deformation observed experimentally, we suggest possible roles for such integrative models in clinical diagnosis.