Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study

0522860 - ÚT 2021 RIV US eng J - Článek v odborném periodiku
Vaverka, J. - Moudr, J. - Lokaj, P. - Burša, J. - Pásek, Michal
Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study.
BioMed Research International. Roč. 2020, April (2020), č. článku 2867865. ISSN 2314-6133. E-ISSN 2314-6141
Institucionální podpora: RVO:61388998
Klíčová slova: heart contraction * left ventricle * finite element model * blood circuit model * conduction velocity
Obor OECD: 3.5 Other medical sciences
Impakt faktor: 3.411, rok: 2020
Způsob publikování: Open access
https://pubmed.ncbi.nlm.nih.gov/32337235/

This study investigates the impact of reduced transmural conduction velocity (TCV) on output parameters of human heart. In healthy heart, the TCV contributes to synchronization of the onset of contraction in individual layers of left ventricle (LV). However, it is unclear whether the clinically observed decrease of TCV contributes significantly to a reduction of LV contractility. The applied three-dimensional finite element model of isovolumic contraction of human LV incorporates transmural gradients in electromechanical delay and myocyte shortening velocity, and evaluates the impact of TCV reduction on pressure rise (namely (dP/dt)max) and on isovolumic contraction duration (IVCD) in a healthy LV. The model outputs are further exploited in the lumped “Windkessel” model of human cardiovascular system (based on electrohydrodynamic analogy of respective differential equations) to simulate the impact of changes of (dP/dt)max and IVCD on chosen systemic parameters (ejection fraction, LV power, cardiac output, blood pressure). The simulations have shown that 50% decrease in TCV prolongs substantially the isovolumic contraction, decelerates slightly the LV pressure rise, increases the LV energy consumption, and reduces the LV power. These negative effects increase progressively with further reduction of TCV. In conclusion, these results suggest that the pumping efficacy of human LV decreases with lower TCV due to a higher energy consumption and lower LV power. Although the changes induced by the clinically relevant reduction of TCV are not critical for healthy heart, they may represent an important factor limiting the heart function under disease conditions.
Trvalý link: http://hdl.handle.net/11104/0315827