Dyssynchronous Left Ventricular Activation is Insufficient for the Breakdown of Wringing Rotation.

Autor:	Gerach T; Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany., Appel S; Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany., Wilczek J; Department of Electrocardiology, Upper-Silesian Heart Center, Katowice, Poland.; Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland., Golba KS; Department of Electrocardiology, Upper-Silesian Heart Center, Katowice, Poland.; Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland., Jadczyk T; Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.; Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic., Loewe A; Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in physiology [Front Physiol] 2022 May 09; Vol. 13, pp. 838038. Date of Electronic Publication: 2022 May 09 (Print Publication: 2022).
DOI:	10.3389/fphys.2022.838038
Abstrakt:	Cardiac resynchronization therapy is a valuable tool to restore left ventricular function in patients experiencing dyssynchronous ventricular activation. However, the non-responder rate is still as high as 40%. Recent studies suggest that left ventricular torsion or specifically the lack thereof might be a good predictor for the response of cardiac resynchronization therapy. Since left ventricular torsion is governed by the muscle fiber orientation and the heterogeneous electromechanical activation of the myocardium, understanding the relation between these components and the ability to measure them is vital. To analyze if locally altered electromechanical activation in heart failure patients affects left ventricular torsion, we conducted a simulation study on 27 personalized left ventricular models. Electroanatomical maps and late gadolinium enhanced magnetic resonance imaging data informed our in-silico model cohort. The angle of rotation was evaluated in every material point of the model and averaged values were used to classify the rotation as clockwise or counterclockwise in each segment and sector of the left ventricle. 88% of the patient models ( n = 24) were classified as a wringing rotation and 12% ( n = 3) as a rigid-body-type rotation. Comparison to classification based on in vivo rotational NOGA XP maps showed no correlation. Thus, isolated changes of the electromechanical activation sequence in the left ventricle are not sufficient to reproduce the rotation pattern changes observed in vivo and suggest that further patho-mechanisms are involved. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Gerach, Appel, Wilczek, Golba, Jadczyk and Loewe.)
Databáze:	MEDLINE
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