Document Detail


A computational approach to understanding the cardiac electromechanical activation sequence in the normal and failing heart, with translation to the clinical practice of CRT.
MedLine Citation:
PMID:  22884712     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiac resynchronization therapy (CRT) is an established clinical treatment modality that aims to recoordinate contraction of the heart in dyssynchrous heart failure (DHF) patients. Although CRT reduces morbidity and mortality, a significant percentage of CRT patients fail to respond to the therapy, reflecting an insufficient understanding of the electromechanical activity of the DHF heart. Computational models of ventricular electromechanics are now poised to fill this knowledge gap and provide a comprehensive characterization of the spatiotemporal electromechanical interactions in the normal and DHF heart. The objective of this paper is to demonstrate the powerful utility of computational models of ventricular electromechanics in characterizing the relationship between the electrical and mechanical activation in the DHF heart, and how this understanding can be utilized to devise better CRT strategies. The computational research presented here exploits knowledge regarding the three dimensional distribution of the electromechanical delay, defined as the time interval between myocyte depolarization and onset of myofiber shortening, in determining the optimal location of the LV pacing electrode for CRT. The simulation results shown here also suggest utilizing myocardial efficiency and regional energy consumption as a guide to optimize CRT.
Authors:
Jason Constantino; Yuxuan Hu; Natalia A Trayanova
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.; Review     Date:  2012-08-01
Journal Detail:
Title:  Progress in biophysics and molecular biology     Volume:  110     ISSN:  1873-1732     ISO Abbreviation:  Prog. Biophys. Mol. Biol.     Publication Date:    2012 Oct-Nov
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-11-25     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  0401233     Medline TA:  Prog Biophys Mol Biol     Country:  England    
Other Details:
Languages:  eng     Pagination:  372-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiac Resynchronization Therapy / methods*
Computer Simulation*
Electrophysiological Processes*
Heart / physiology*,  physiopathology*
Heart Failure / physiopathology,  therapy*
Humans
Mechanical Processes*
Grant Support
ID/Acronym/Agency:
F31-HL103090/HL/NHLBI NIH HHS; R01 HL103428/HL/NHLBI NIH HHS; R01-HL103428/HL/NHLBI NIH HHS
Comments/Corrections

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