Journal article
Human biventricular electromechanical simulations on the progression of electrocardiographic and mechanical abnormalities in post-myocardial infarction
- Abstract:
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Aims
Develop, calibrate and evaluate with clinical data a human electromechanical modelling and simulation framework for multiscale, mechanistic investigations in healthy and post-myocardial infarction (MI) conditions, from ionic to clinical biomarkers.Methods and results
Human healthy and post-MI electromechanical simulations were conducted with a novel biventricular model, calibrated and evaluated with experimental and clinical data, including torso/biventricular anatomy from clinical magnetic resonance, state-of-the-art human-based membrane kinetics, excitation–contraction and active tension models, and orthotropic electromechanical coupling. Electromechanical remodelling of the infarct/ischaemic region and the border zone were simulated for ischaemic, acute, and chronic states in a fully transmural anterior infarct and a subendocardial anterior infarct. The results were compared with clinical electrocardiogram and left ventricular ejection fraction (LVEF) data at similar states. Healthy model simulations show LVEF 63%, with 11% peak systolic wall thickening, QRS duration and QT interval of 100 ms and 330 ms. LVEF in ischaemic, acute, and chronic post-MI states were 56%, 51%, and 52%, respectively. In linking the three post-MI simulations, it was apparent that elevated resting potential due to hyperkalaemia in the infarcted region led to ST-segment elevation, while a large repolarization gradient corresponded to T-wave inversion. Mechanically, the chronic stiffening of the infarct region had the benefit of improving systolic function by reducing infarct bulging at the expense of reducing diastolic function by inhibiting inflation.Conclusion
Our human-based multiscale modelling and simulation framework enables mechanistic investigations into patho-physiological electrophysiological and mechanical behaviour and can serve as testbed to guide the optimization of pharmacological and electrical therapies.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 1.7MB, Terms of use)
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- Publisher copy:
- 10.1093/europace/euaa405
Authors
- Publisher:
- Oxford University Press
- Journal:
- EP-Europace More from this journal
- Volume:
- 23
- Issue:
- S1
- Pages:
- i143–i152
- Publication date:
- 2021-03-04
- Acceptance date:
- 2020-12-14
- DOI:
- EISSN:
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1532-2092
- ISSN:
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1099-5129
- Language:
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English
- Keywords:
- Pubs id:
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1160434
- Local pid:
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pubs:1160434
- Deposit date:
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2021-02-09
Terms of use
- Copyright holder:
- Wang et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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