表征心室复极不一致有效参数仿真的研究.pdf

Abstract Ithasshownthatthespatialheterogeneityinventricularrepolarization,enabling reentry,isthemaincauseofarrhythmia.Thevalidmethodtoevaluatethis heterogeneiytismeasuringthedispersionofsomeparameterssuchasQTintervalsand ARls(activationrecoveryintervals)rfombodysurfaceelectrocardiogram.However, theeffectivenessofthisrepresentationhasbeencontroversy.Theaimofthisarticleis tostudytheoreticallythebiophysicalmeaningofQTinterval、ARIandtheir dispersions,andtostudytheirrelationbetweenthetwoparametersandthe heterogeneiytinventricularrepolarization Aone-dimensionbidomainmodelofmyocardium withelectricexcitation conductingrfomendocardiumtoepicardiumwasestablishedinthestudy,andthe heterogeneiytofventricularrepolarizationwasproducedbychangingtheischemic degreeandregion.Inthemodel,theextracellularpotentialwascalculated饰thefinite differencemethod,rfomwhichtheQTdispersionandARIdispersionwerethen obtained.Itshowedthattheextracellularpotentialinischemicregionchanges obviously,suchasbaselinedescends,STsegmentshortensandelevates,T-wave becomeshighandbroadandsoon.TherewasnoobviousdifferenceinQTinterval betweenischemicregionandnormalregion.Thus,QTdispersionwasclosetozero, anditcannoteffectivelyrepresenttheheterogeneiytinventricularrepolarization. However,therewasobviousdifferenceinARIbetweenischemicregionandnormal region,andtheARIdispersionwascorrespondingwithischemicdegree.Thereforeit caneffectivelyrepresenttheheterogeneiytinventricularrepolarization. Basedontheone-dimensionmodel,two-dimensionandthree-dimensionmodels wereestablishedtostudyhowtheheterogeneityinventricularrepolarizationchanges QTintervalsandARIs,andtovalidatetheresultofone-dimensionmodel.We concludedthatQTintervalinbothischemicandnormalregion,measuredfromthe beginningofactivationtotheendofrecovery,actuallyrepresentsthetimeintervalof cellularrepolarizationinwholeheart,soQTdispersioncannotrepresentthe heterogeneiytinventricularrepolarization.Howe