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Biomechanical, neurohormonal, and genetic stimuli drive these patterns through changes in myocyte dimension and fibrosis. We propose a novel microstructure-motivated model that predicts organ-scale G&amp;R in the heart based on the homogenized constrained mixture theory. Previous models, based on the kinematic growth theory, reproduced consequences of G&amp;R in bulk myocardial tissue by prescribing the direction and extent of growth but neglected underlying cellular mechanisms. In our model, the direction and extent of G&amp;R emerge naturally from intra- and extracellular turnover processes in myocardial tissue constituents and their preferred homeostatic stretch state. We additionally propose a method to obtain a mechanobiologically equilibrated reference configuration. We test our model on an idealized 3D left ventricular geometry and demonstrate that our model aims to maintain tensional homeostasis in hypertension conditions. In a stability map, we identify regions of stable and unstable G&amp;R from an identical parameter set with varying systolic pressures and growth factors. Furthermore, we show the extent of G&amp;R reversal after returning the systolic pressure to baseline following stage 1 and 2 hypertension. A realistic model of organ-scale cardiac G&amp;R has the potential to identify patients at risk of heart failure, enable personalized cardiac therapies, and facilitate the optimal design of medical devices.<\/jats:p>","DOI":"10.1007\/s10237-023-01747-w","type":"journal-article","created":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T12:01:26Z","timestamp":1690113686000},"page":"1983-2002","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A homogenized constrained mixture model of cardiac growth and remodeling: analyzing mechanobiological stability and reversal"],"prefix":"10.1007","volume":"22","author":[{"given":"Amadeus M.","family":"Gebauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin R.","family":"Pfaller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian A.","family":"Braeu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J.","family":"Cyron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang A.","family":"Wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,23]]},"reference":[{"key":"1747_CR1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.cobme.2019.09.005","volume":"11","author":"Y Aboelkassem","year":"2019","unstructured":"Aboelkassem Y, Powers JD, McCabe KJ, McCulloch AD (2019) Multiscale models of cardiac muscle biophysics and tissue remodeling in hypertrophic cardiomyopathies. 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