Heart failure remains a leading cause of morbidity and mortality worldwide, which is intrinsically linked with the very limited regenerative capacity of the adult human heart. Unlike lower vertebrates, adult mammalian cardiomyocytes proliferate minimally after injury, leading to maladaptive remodeling and progressive dysfunction. However, there is growing evidence that mechanical cues strongly influence myocardial biology. Mechanical overload contributes to pathological remodeling, while mechanical unloading can favor cardiomyocyte cycling and promote cardiac regeneration. These observations span across several pre-clinical cardiac models up to clinical studies. A number of therapies focused on reducing the mechanical forces in the myocardium, including profound mechanical unloading by left ventricular assist devices (LVADs), have been shown to promote reverse remodeling. This process is characterized by normative changes at the structural, molecular, and functional levels. In rare cases, myocardial reverse remodeling is so pronounced that it allows for device explantation. Hence, while some evidence suggests that mechanical therapy can significantly improve patient outcomes, the precise mechanisms driving reverse remodeling upon unloading and the link with cardiac regeneration remain elusive.
Project description This PhD project will explore how mechanical forces affect the regenerative capacity of the heart, with the ultimate goal of identifying mechano-biological mechanisms that could be harnessed for therapy. The work will span multiple experimental models, from
in vitro cellular systems, engineered cardiac constructs, living myocardial slices, whole explanted hearts and animal models of cardiac unloading. Complementing these experimental approaches, the PhD candidate will have access to cardiac samples and datasets from patients undergoing LVAD-mediated mechanical unloading.
Key objectives include: - Dissecting the cellular and molecular mechanisms by which mechanical forces regulate cardiomyocyte proliferation, survival, and function.
- Characterizing regenerative responses in biomimetic platforms such as engineered heart tissue and myocardial slices under controlled loading and unloading conditions.
- Investigating molecular signatures of reverse remodeling in human cardiac tissue and patient-derived data.