CHARACTERIZATION OF 3D STRAIN WITHIN THE REMOTE MYOCARDIUM OF PATIENTS WITH ISCHEMIC CARDIOMYOPATHY

2016 ◽  
Vol 32 (10) ◽  
pp. S94
Author(s):  
B. Heydari ◽  
A. Satriano ◽  
K. Fenwick ◽  
D. Waters ◽  
Y. Mikami ◽  
...  
1998 ◽  
Vol 31 ◽  
pp. 256
Author(s):  
S. Firoozan ◽  
K. Wei ◽  
A. Linka ◽  
D. Skyba ◽  
N.C. Goodman ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Konstantinos N. Aronis ◽  
Adityo Prakosa ◽  
Teya Bergamaschi ◽  
Ronald D. Berger ◽  
Patrick M. Boyle ◽  
...  

RationalePatients with ischemic cardiomyopathy (ICMP) are at high risk for malignant arrhythmias, largely due to electrophysiological remodeling of the non-infarcted myocardium. The electrophysiological properties of the non-infarcted myocardium of patients with ICMP remain largely unknown.ObjectivesTo assess the pro-arrhythmic behavior of non-infarcted myocardium in ICMP patients and couple computational simulations with machine learning to establish a methodology for the development of disease-specific action potential models based on clinically measured action potential duration restitution (APDR) data.Methods and ResultsWe enrolled 22 patients undergoing left-sided ablation (10 ICMP) and compared APDRs between ICMP and structurally normal left ventricles (SNLVs). APDRs were clinically assessed with a decremental pacing protocol. Using genetic algorithms (GAs), we constructed populations of action potential models that incorporate the cohort-specific APDRs. The variability in the populations of ICMP and SNLV models was captured by clustering models based on their similarity using unsupervised machine learning. The pro-arrhythmic potential of ICMP and SNLV models was assessed in cell- and tissue-level simulations. Clinical measurements established that ICMP patients have a steeper APDR slope compared to SNLV (by 38%, p < 0.01). In cell-level simulations, APD alternans were induced in ICMP models at a longer cycle length compared to SNLV models (385–400 vs 355 ms). In tissue-level simulations, ICMP models were more susceptible for sustained functional re-entry compared to SNLV models.ConclusionMyocardial remodeling in ICMP patients is manifested as a steeper APDR compared to SNLV, which underlies the greater arrhythmogenic propensity in these patients, as demonstrated by cell- and tissue-level simulations using action potential models developed by GAs from clinical measurements. The methodology presented here captures the uncertainty inherent to GAs model development and provides a blueprint for use in future studies aimed at evaluating electrophysiological remodeling resulting from other cardiac diseases.


Kardiologiia ◽  
2019 ◽  
Vol 59 (9) ◽  
pp. 71-82
Author(s):  
V. M. Shipulin ◽  
A. S. Pryakhin ◽  
S. L. Andreev ◽  
V. V. Shipulin ◽  
B. N. Kozlov

In this article we present discussion of the current state of the problem of surgical treatment of ischemic cardiomyopathy (ICM). The pathophysiological aspects of left ventricular remodeling in patients with ICM are also covered. A detailed characterization of methods for assessing the myocardial viability is given and their role in patients with ICM is shown. The problem of right ventricular dysfunction in ICM is discussed. Main attention is focused on the methods of surgical treatment of ICM. Limitations of the Surgical Treatment for Ischemic Heart Failure (STICH) study are analyzed. The article is intended for cardiologists, general practitioners and cardiac surgeons.


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