Pro-arrhythmogenic effects of atrial fibrillation-induced electrical remodelling: insights from the three-dimensional virtual human atria.
Pro-arrhythmogenic effects of atrial fibrillation-induced electrical remodelling: insights from the three-dimensional virtual human atria.
复制标题
心房颤动引起的电重塑的致心律失常效应：来自三维虚拟人体心房的见解
DOI：
10.1113/jphysiol.2013.254987
复制
发表时间：
2013-09-01
期刊：
影响因子：
--
通讯作者：
Zhang H
中科院分区：
文献类型：
--
作者：
Colman MA;Aslanidi OV;Kharche S;Boyett MR;Garratt C;Hancox JC;Zhang H
慢性心房颤动（AF）与心房结构和电重构有关，这与房颤的高复发率有关。通过生物物理详细的计算机建模，本研究调查了房颤诱导的电重构促进和延续房颤的机制。考虑到固有的心房电生理特性，进行了修改，以纳入af诱导的主要离子通道电流（ICaL, IKur, Ito, IK1, IKs, INaCa）变化和细胞内Ca2+处理的各种实验数据集。对照和af重构条件下的单细胞模型被纳入多细胞三维（3D）心房组织模型。心房电重构的影响被量化为心房电重构的AP轮廓、AP持续时间（APD）及其在心房中的弥散度的变化，以及心房组织对再入起始的易感性。对三维模型中重入激励波的动态特性进行了表征。在我们的模拟中，af诱导的电重构不均匀地跨心房缩短心房APD；这导致APD相对较短，且终末嵴/突起肌、肺静脉/左心房连接处APD存在明显的区域差异。结果，在这些组织连接处，测量到的组织对再入起始的易感性增加了。af诱导的电重构也稳定和加速了再入激励波，导致快速和持续的再入。在af重塑条件下，三维模型中的重入涡旋波退化为持续且不稳定的小波，导致纤颤。总之，真实的三维心房组织模型表明af诱导的电重构产生区域异质性和缩短的APD；它们分别促进了再入激励波的产生和维持。
Chronic atrial fibrillation (AF) is associated with structural and electrical remodelling in the atria, which are associated with a high recurrence of AF. Through biophysically detailed computer modelling, this study investigated mechanisms by which AF-induced electrical remodelling promotes and perpetuates AF. A family of Courtemanche–Ramirez–Nattel variant models of human atrial cell action potentials (APs), taking into account of intrinsic atrial electrophysiological properties, was modified to incorporate various experimental data sets on AF-induced changes of major ionic channel currents (ICaL, IKur, Ito, IK1, IKs, INaCa) and on intracellular Ca2+ handling. The single cell models for control and AF-remodelled conditions were incorporated into multicellular three-dimensional (3D) atrial tissue models. Effects of the AF-induced electrical remodelling were quantified as the changes of AP profile, AP duration (APD) and its dispersion across the atria, and the vulnerability of atrial tissue to the initiation of re-entry. The dynamic behaviour of re-entrant excitation waves in the 3D models was characterised. In our simulations, AF-induced electrical remodelling abbreviated atrial APD non-uniformly across the atria; this resulted in relatively short APDs co-existing with marked regional differences in the APD at junctions of the crista terminalis/pectinate muscle, pulmonary veins/left atrium. As a result, the measured tissue vulnerability to re-entry initiation at these tissue junctions was increased. The AF-induced electrical remodelling also stabilized and accelerated re-entrant excitation waves, leading to rapid and sustained re-entry. Under the AF-remodelled condition, re-entrant scroll waves in the 3D model degenerated into persistent and erratic wavelets, leading to fibrillation. In conclusion, realistic 3D atrial tissue models indicate that AF-induced electrical remodelling produces regionally heterogeneous and shortened APD; these respectively facilitate initiation and maintenance of re-entrant excitation waves.
登录
查看更多内容
DOI：
10.1109/iembs.2011.6090486
发表时间：
2011
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
--
作者：
Aslanidi OV;Butters TD;Ren CX;Ryecroft G;Zhang H
通讯作者：
Zhang H
影响因子：
37.8
作者：
Chen, SA;Hsieh, MH;Chang, MS
通讯作者：
Chang, MS
影响因子：
6.1
作者：
Calkins, Hugh;Kuck, Karl Heinz;Vardas, Panos E.
通讯作者：
Vardas, Panos E.
DOI：
10.1152/ajpheart.01242.2003
发表时间：
2004-06-01
影响因子：
4.8
作者：
Burashnikov, A;Mannava, S;Antzelevitch, C
通讯作者：
Antzelevitch, C
DOI：
10.1002/ar.21379
发表时间：
2011-06-01
影响因子：
2
作者：
Chandler, Natalie;Aslanidi, Oleg V.;Dobrzynski, Halina
通讯作者：
Dobrzynski, Halina