The effects of remodeling with heart failure on mode of initiation of ventricular fibrillation and its spatiotemporal organization.
The effects of remodeling with heart failure on mode of initiation of ventricular fibrillation and its spatiotemporal organization.
复制标题
心力衰竭重构对心室颤动起始模式及其时空组织的影响。
DOI：
10.1007/s10840-015-0016-2
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Olgin,JeffreyE
中科院分区：
文献类型：
--
作者：
Everett4th,ThomasH;Hulley,GeorgeS;Lee,KenW;Chang,Roger;Wilson,EmilyE;Olgin,JeffreyE
目的心力衰竭底物在心室颤动（VF）发生中的作用及其机制尚不清楚。本研究的目的是确定基板上VF启动及其时空组织在heart failure model.MethodsOptical动作电位的影响，记录从LV楔准备无论是从结构正常的心脏（对照，n= 11）或充血性心力衰竭（CHF;n= 7），在心外膜表面，endoorthogonal表面，其中包括乳头肌，和透壁横截面。测定动作电位时程（APD 80），并启动VF。A快速傅立叶变换计算，和主频率（DF）determined.ResultsThe CHF组显示增加VF脆弱性（69比26%，p< 0.03），和每个映射表面显示APD 80梯度，其中包括岛屿较高APD的透壁表面（M细胞），这是没有观察到在对照组。CHF组的VF特征为稳定、离散、高DF区域，与位于乳头肌部位透壁表面的病灶或螺旋波相关。总的来说，前10%的DF与APD 101 ms相关，而后10%的DF与APD 126 ms相关（p< 0.01）。结论在CHF模型中，APD梯度与VF易感性增加相关，最高稳定DF位于透壁表面，这在对照组中未见。这表明CHF基底产生独特的APD和DF特性。
PurposeThe effect of the heart failure substrate on the initiation of ventricular fibrillation (VF) and its resulting mechanism is not known. The objective of this study was to determine the effects of substrate on VF initiation and its spatiotemporal organization in the heart failure model.MethodsOptical action potentials were recorded from LV wedge preparations either from structurally normal hearts (control,n= 11) or from congestive heart failure (CHF;n= 7), at the epicardial surface, endocardial surface which included a papillary muscle, and a transmural cross section. Action potential duration (APD80) was determined, and VF was initiated. A fast Fourier transform was calculated, and the dominant frequency (DF) was determined.ResultsThe CHF group showed increased VF vulnerability (69 vs 26 %,p< 0.03), and every mapped surface showed an APD80gradient which included islands of higher APDs on the transmural surface (M cells) which was not observed in controls. VF in the CHF group was characterized by stable, discrete, high-DF areas that correlated to either foci or spiral waves located on the transmural surface at the site of the papillary muscle. Overall, the top 10 % of DFs correlated to an APD of 101 ms while the bottom 10 % of DFs correlated to an APD of 126 ms (p< 0.01).ConclusionsIn the CHF model, APD gradients correlated with an increased vulnerability to VF, and the highest stable DFs were located on the transmural surface which was not seen in controls. This indicates that the CHF substrate creates unique APD and DF characteristics.