Electromechanical computational modelling of heart failure provides extensive analysis of cardiac pathophysiological features

Purpose: This study introduces a novel computational framework for simulating the cardiac function in both healthy and post-myocardial infarction hearts to model heart failure with reduced ejection fraction (HFrEF). By integrating biomechanical deformation, electromechanical coupling, and haemodynamic feedback, the model provides a comprehensive analysis of heart failure progression. Methods: A physiologically detailed 3D-0D electromechanical model was used to simulate pressure volume loops under different pathological conditions, including post-myocardial infarction and HFrEF. The model incorporates haemody-namic coupling with an electromechanical framework to quantify left ventricular performance markers in virtual scenarios. Additionally, myocardial strains along the principal fiber direction were computed to assess systolic dysfunction and deformation. Results: The simulations accurately captured the impact of HFrEF on electrophysiological and mechanical properties. The computationally-derived PV loops demonstrated a strong agreement with clinical findings, highlighting key features of HFrEF such as reduced stroke volume, impaired contractility, and decreased ejection fraction. Furthermore, scar-related conduction abnormalities were associated with an increased risk of ventricular tachycardia, with failing hearts exhibiting greater haemodynamic instability during arrhythmic episodes. Conclusions: The proposed computational framework provides a powerful tool for investigating HFrEF progression and electromechanical dysfunction. By accurately replicating PV loop characteristics and haemodynamic alterations commonly seen in clinical settings, this model enhances the understanding of HFrEF and may support the development of targeted therapeutic strategies.