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Biomechanics of Cardiovascular Remodeling

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Biophysics".

Deadline for manuscript submissions: 30 October 2026 | Viewed by 3906

Special Issue Editors


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Guest Editor
Department of Cardiology II & III, University Hospital of Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
Interests: implantable cardioverter defibrillators; defibrillation; sudden cardiac death; catheter ablation; cardiac electrophysiologic; risk stratification for sudden cardiac death; biomarkers for development or progression of cardiac diseases
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Guest Editor
Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany
Interests: heart failure; chronic heart failure; clinical cardiology; clinical research

Special Issue Information

Dear Colleagues,

The current Special Issue aims at highlighting new scientific evidence in the field of cardiovascular remodeling, including all aspects of its underlying mechanisms and clinical outcomes.

Cardiac remodeling is a crucial key process in understanding and positively influencing the course of cardiovascular diseases. Most pharmaceutical therapies aim at altering signaling pathways in order to positively influence cardiac remodeling. However, many of the underlying mechanisms remain to be elucidated.

Manuscripts on biomechanical, biochemical, and biophysical mechanisms leading to cardiovascular remodeling and its subsequent unfavorable outcome are equally welcome as studies on trials on pharmacological or interventional (e.g., PCI, device therapy, structural interventions) influences on cardiac remodeling. Furthermore, models predicting unfavorable or favorable remodeling, e.g., using AI, are suitable as well. The same is true for studies including cardiac imaging illustrating cardiac remodeling and its consequences.

We strongly encourage all manuscripts related to this field to be submitted. We will take care for a quick and thorough review process and are looking forward to receiving your submissions.

This Special Issue is supervised by PD Dr. Kevin Willy and PD Dr. Philipp Maximilian Doldi and assisted by Dr. Florian Doldi and Dr. Julian Wolfes (University Hospital of Münster, Munster, Germany).

Dr. Kevin Willy
Dr. Maximilian Doldi Philipp
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • cardiovascular remodeling
  • cardiac imaging
  • cardiovascular intervention
  • cardiovascular pathways
  • cardiovascular research
  • structural heart disease
  • cellular signaling

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Published Papers (2 papers)

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Research

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16 pages, 2328 KB  
Article
Valve-Dependent Regional Heterogeneity of Wall Mechanics and Collagen Remodeling in Ascending Thoracic Aortic Aneurysms
by Caroline Radner, Sandra Schmid, Moritz Sunderdiek, Yelyzaveta Sitnikova, Clara Hellmich, Linda Grefen, Maximilian Grab, Oliver Buchstab, Thomas Fabry, Nadja Sachs, Christian Hagl, Maximilian Pichlmaier, Sven Peterss and Joscha Buech
Int. J. Mol. Sci. 2026, 27(6), 2658; https://doi.org/10.3390/ijms27062658 - 14 Mar 2026
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Abstract
Ascending thoracic aortic aneurysm (ATAA) pathogenesis varies with aortic valve morphology, yet regional heterogeneity between inner curvature (IC) and outer curvature (OC) remains incompletely characterized. We hypothesized that regional differences between the outer and inner curvature of the ascending aorta are valve-morphology dependent [...] Read more.
Ascending thoracic aortic aneurysm (ATAA) pathogenesis varies with aortic valve morphology, yet regional heterogeneity between inner curvature (IC) and outer curvature (OC) remains incompletely characterized. We hypothesized that regional differences between the outer and inner curvature of the ascending aorta are valve-morphology dependent and reflect distinct remodeling mechanisms in bicuspid versus tricuspid aortic valve-associated aortopathy. Ascending aortic tissue from 155 patients (69 tricuspid aortic valve [TAV], 68 bicuspid aortic valve [BAV], 18 non-aneurysmal heart transplantation [HTx] controls) underwent uniaxial tensile testing (n = 66), histological analysis, hydroxyproline assay, and reverse transcription quantitative PCR (RT-qPCR) for collagen (COL1A1, COL3A1, COL4A1, COL5A1, COL11A1) and elastin (ELN) genes. The OC was thinner than the IC in both TAV and BAV (p < 0.001), with no regional differences in HTx. TAV demonstrated increased OC stiffness (E-modulus 0.60 ± 0.31 vs. 0.43 ± 0.24 MPa, p = 0.004) with reduced failure strain (p = 0.013). BAV showed preserved stiffness but reduced OC extensibility (ε_max 56.5 ± 15.1% vs. 72.4 ± 21.7%, p < 0.001). BAV exhibited elevated OC collagen content (hydroxyproline OC/IC ratio 1.42, p = 0.048), whereas TAV showed reduced OC elastin area (p < 0.01). All collagen genes were upregulated at the OC in both TAV (all p < 0.001) and BAV (all p < 0.05), with COL11A1 showing the highest fold change (3.4-fold in TAV). ELN was reduced at the OC in TAV (p < 0.001) but unchanged in BAV. ATAAs exhibit distinct valve-dependent regional heterogeneities. The discordance between collagen gene expression and protein content suggests valve-specific differences in collagen regulation. These findings support distinct pathomechanisms and highlight the limitations of diameter-based risk stratification, motivating further investigation of regional wall assessment as a complement to current size criteria for surgical decision-making. Full article
(This article belongs to the Special Issue Biomechanics of Cardiovascular Remodeling)
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Review

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16 pages, 533 KB  
Review
Right Ventricular Dynamics in Tricuspid Regurgitation: Insights into Reverse Remodeling and Outcome Prediction Post Transcatheter Valve Intervention
by Philipp M. Doldi, Manuela Thienel and Kevin Willy
Int. J. Mol. Sci. 2025, 26(13), 6322; https://doi.org/10.3390/ijms26136322 - 30 Jun 2025
Viewed by 2527
Abstract
Tricuspid regurgitation (TR) represents a significant, often silently progressing, valvular heart disease with historically suboptimal management due to perceived high surgical risks. Transcatheter tricuspid valve interventions (TTVI) offer a promising, less invasive therapeutic avenue. Central to the success of TTVI is Right Ventricular [...] Read more.
Tricuspid regurgitation (TR) represents a significant, often silently progressing, valvular heart disease with historically suboptimal management due to perceived high surgical risks. Transcatheter tricuspid valve interventions (TTVI) offer a promising, less invasive therapeutic avenue. Central to the success of TTVI is Right Ventricular Reverse Remodelling (RVRR), defined as an improvement in RV structure and function, which strongly correlates with enhanced patient survival. The right ventricle (RV) undergoes complex multi-scale biomechanical maladaptations, progressing from adaptive concentric to maladaptive eccentric hypertrophy, coupled with increased stiffness and fibrosis. Molecular drivers of this pathology include early failure of antioxidant defenses, metabolic shifts towards glycolysis, and dysregulation of microRNAs. Accurate RV function assessment necessitates advanced imaging modalities like 3D echocardiography, Cardiac Magnetic Resonance Imaging (CMR), and Computed Tomography (CT), along with strain analysis. Following TTVI, RVRR typically manifests as a biphasic reduction in RV volume overload, improved myocardial strain, and enhanced RV-pulmonary arterial coupling. Emerging molecular biomarkers alongside advanced imaging-derived biomechanical markers like CT-based 3D-TAPSE and RV longitudinal strain, are proving valuable. Artificial intelligence (AI) and machine learning (ML) are transforming prognostication by integrating diverse clinical, laboratory, and multi-modal imaging data, enabling unprecedented precision in risk stratification and optimizing TTVI strategies. Full article
(This article belongs to the Special Issue Biomechanics of Cardiovascular Remodeling)
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