analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model分析后的再分配工作心脏同步模式治疗病人具体的模型.pdfVIP

Analyses of the Redistribution of Work following Cardiac Resynchronisation Therapy in a Patient Specific Model 1 2 3 1 1,4 Steven Alexander Niederer , Pablo Lamata , Gernot Plank , Phani Chinchapatnam , Matt Ginks , Kawal Rhode1, Christopher Aldo Rinaldi1,4, Reza Razavi1,4, Nicolas Peter Smith1,2* 1 Imaging Sciences Biomedical Engineering Division, King’s College London, London, United Kingdom, 2 Computing Laboratory, University of Oxford, Oxford, United ¨ ¨ Kingdom, 3 Institut fur Biophysik, Medizinische Universitat Graz, Graz, Austria, 4 Department of Cardiology, St Thomas’ Hospital, London, United Kingdom Abstract Regulation of regional work is essential for efficient cardiac function. In patients with heart failure and electrical dysfunction such as left branch bundle block regional work is often depressed in the septum. Following cardiac resynchronisation therapy (CRT) this heterogeneous distribution of work can be rebalanced by altering the pattern of electrical activation. To investigate the changes in regional work in these patients and the mechanisms underpinning the improved function following CRT we have developed a personalised computational model. Simulations of electromechanical cardiac function in the model estimate the regional stress, strain and work pre- and post-CRT. These simulations predict that the increase in observed work performed by the septum following CRT is not due to an increase in the volume of myocardial tissue recruited during contraction but rather that the volume of recruited myocardium remains the same and the average peak work rate per unit vol