Effects of cardiac growth on electrical dyssynchrony in the single ventricle patient
Effects of cardiac growth on electrical dyssynchrony in the single ventricle patient
复制标题
心脏生长对单心室患者电不同步的影响
DOI：
10.1080/10255842.2023.2222203
复制
发表时间：
2023
影响因子：
1.6
通讯作者：
Marsden, A. L.
中科院分区：
文献类型：
--
作者：
Tikenoğulları, O. Z.;Peirlinck, M.;Chubb, H.;Dubin, A. M.;Kuhl, E.;Marsden, A. L.
单心室患者，包括患有左心发育不全综合征 (HLHS) 的患者，通常会接受三次姑息性心脏手术，最终进行 Fontan 手术。 HLHS 与高发病率和死亡率相关，许多患者出现心律失常、电不同步，并最终出现心室衰竭。然而，HLHS 生理学中心室扩大和电功能障碍之间的相关性仍然知之甚少。在这里，我们使用计算模型来描述 HLHS 中生长和电生理学之间的关系。我们集成了个性化有限元模型、体积生长模型和个性化电生理学模型来执行受控计算机实验。我们发现右心室扩大会对 QRS 时限和心室间不同步产生负面影响。相反，左心室扩大可以部分补偿这种不同步。这些发现对我们理解电不同步的起源以及最终对 HLHS 患者的治疗具有潜在的影响。
Single ventricle patients, including those with hypoplastic left heart syndrome (HLHS), typically undergo three palliative heart surgeries culminating in the Fontan procedure. HLHS is associated with high rates of morbidity and mortality, and many patients develop arrhythmias, electrical dyssynchrony, and eventually ventricular failure. However, the correlation between ventricular enlargement and electrical dysfunction in HLHS physiology remains poorly understood. Here we characterize the relationship between growth and electrophysiology in HLHS using computational modeling. We integrate a personalized finite element model, a volumetric growth model, and a personalized electrophysiology model to perform controlled in silico experiments. We show that right ventricle enlargement negatively affects QRS duration and interventricular dyssynchrony. Conversely, left ventricle enlargement can partially compensate for this dyssynchrony. These findings have potential implications on our understanding of the origins of electrical dyssynchrony and, ultimately, the treatment of HLHS patients.