Vectorcardiography-derived index allows a robust quantification of ventricular electrical synchrony.

Autor: Fernández JMF; Systems Biology Group (SysBio), Institute of Physics of Liquids and Biological Systems (IFLySIB), National Scientific and Technical Research Council (CONICET), University of La Plata, La Plata, Argentina., Spagnuolo DN; Systems Biology Group (SysBio), Institute of Physics of Liquids and Biological Systems (IFLySIB), National Scientific and Technical Research Council (CONICET), University of La Plata, La Plata, Argentina., Politi MT; Laboratory of Biomembranes, Institute of Physiology and Biophysics Bernardo Houssay (IFIBIO Houssay), School of Medicine, University of Buenos Aires, Buenos Aires, Argentina., Tello Santacruz IA; Cardiology Department, British Hospital of Buenos Aires, Buenos Aires, Argentina., Schiavone M; Cardiology Department, British Hospital of Buenos Aires, Buenos Aires, Argentina., Cáceres Monié C; Cardiology Department, British Hospital of Buenos Aires, Buenos Aires, Argentina., Avaca HA; Cardiology Department, British Hospital of Buenos Aires, Buenos Aires, Argentina., Chara O; Systems Biology Group (SysBio), Institute of Physics of Liquids and Biological Systems (IFLySIB), National Scientific and Technical Research Council (CONICET), University of La Plata, La Plata, Argentina. osvaldo.chara@tu-dresden.de.; Center for Information Services and High Performance Computing, Technische Universität Dresden, Dresden, Germany. osvaldo.chara@tu-dresden.de.; Instituto de Tecnología, Universidad Argentina de La Empresa (UADE), Buenos Aires, Argentina. osvaldo.chara@tu-dresden.de.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2022 Jun 15; Vol. 12 (1), pp. 9961. Date of Electronic Publication: 2022 Jun 15.
DOI: 10.1038/s41598-022-14000-8
Abstrakt: Alteration of muscle activation sequence is a key mechanism in heart failure with reduced ejection fraction. Successful cardiac resynchronization therapy (CRT), which has become standard therapy in these patients, is limited by the lack of precise dyssynchrony quantification. We implemented a computational pipeline that allows assessment of ventricular dyssynchrony by vectorcardiogram reconstruction from the patient's electrocardiogram. We defined a ventricular dyssynchrony index as the distance between the voltage and speed time integrals of an individual observation and the linear fit of these variables obtained from a healthy population. The pipeline was tested in a 1914-patient population. The dyssynchrony index showed minimum values in heathy controls and maximum values in patients with left bundle branch block (LBBB) or with a pacemaker (PM). We established a critical dyssynchrony index value that discriminates electrical dyssynchronous patterns (LBBB and PM) from ventricular synchrony. In 10 patients with PM or CRT devices, dyssynchrony indexes above the critical value were associated with high time to peak strain standard deviation, an echocardiographic measure of mechanical dyssynchrony. Our index proves to be a promising tool to evaluate ventricular activation dyssynchrony, potentially enhancing the selection of candidates for CRT, device configuration during implantation, and post-implant optimization.
(© 2022. The Author(s).)
Databáze: MEDLINE
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