A bilayermodel of human atria: mathematical background, construction, and assessment
A bilayermodel of human atria: mathematical background, construction, and assessment
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DOI：
10.1093/europace/euu256
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发表时间：
2014-11-01
期刊：
影响因子：
6.1
通讯作者：
Vigmond, Edward
中科院分区：
文献类型：
--
作者：
Labarthe, Simon;Bayer, Jason;Vigmond, Edward
心房数值建模通常将器官表示为具有厚度的表面或组织。虽然表面模型比组织模型具有显著的计算优势，但它们不能完全捕获体内观察到的传播模式，例如心内膜和心外膜之间的活动分离。我们引入一个中间表示，双层模型的人类心房，这是能够重建记录激活patterns.Methods和results我们同时解决了两个表面单域问题，通过形式化的优化方法，设置它们之间的耦合项。两个不同的渐近等价的数值实现的模型。然后，我们建立了一个几何和电生理的详细模型的基础上，CT数据，包括两层的纤维方向，主要的肌肉束，和离散心房耦合的人心房。我们调整了参数，以重现临床测量的激活时间。活化与单层模型进行了比较。激活与在整个心房上测量的生理范围相匹配。界嵴和梳状肌对局部右心房激动很重要，但对总激动时间无显著影响。在双层模型中的传播是类似的单层，但有明显的差异，由于三维传播的纤维方向突然改变了整个墙壁，导致轻微的分离activity.Conclusion心房结构起着主导作用，在确定激活。双层模型能够考虑透壁异质性，同时保持与表面模型相关的低计算负荷。
Aims Atrial numerical modelling has generally represented the organ as either a surface or tissue with thickness. While surface models have significant computational advantages over tissue models, they cannot fully capture propagation patterns seen in vivo, such as dissociation of activity between endo-and epicardium. We introduce an intermediate representation, a bilayer model of the human atria, which is capable of recreating recorded activation patterns.Methods and results We simultaneously solved two surface monodomain problems by formalizing an optimization method to set a coupling term between them. Two different asymptotically equivalent numerical implementations of the model are presented. We then built a geometrically and electrophysiologically detailed model of the human atria based on CT data, including two layers of fibre directions, major muscle bundles, and discrete atrial coupling. We adjusted parameters to recreate clinically measured activation times. Activation was compared with a monolayer model. Activation was fit to the physiological range measured over the entire atria. The crista terminalis and pectinate muscles were important for local right atrial activation, but did not significantly affect total activation time. Propagation in the bilayer model was similar to that of a monolayer, but with noticeable difference, due to three-dimensional propagation where fibre direction changed abruptly across the wall, resulting in a slight dissociation of activity.Conclusion Atrial structure plays the dominant role in determining activation. A bilayer model is able to take into account transmural heterogeneities, while maintaining the low computational load associated with surface models.