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Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study

This study investigates the impact of reduced transmural conduction velocity (TCV) on output parameters of the human heart. In a healthy heart, the TCV contributes to synchronization of the onset of contraction in individual layers of the left ventricle (LV). However, it is unclear whether the clini...

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Autores principales: Vaverka, Jiří, Moudr, Jiří, Lokaj, Petr, Burša, Jiří, Pásek, Michal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160730/
https://www.ncbi.nlm.nih.gov/pubmed/32337235
http://dx.doi.org/10.1155/2020/2867865
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author Vaverka, Jiří
Moudr, Jiří
Lokaj, Petr
Burša, Jiří
Pásek, Michal
author_facet Vaverka, Jiří
Moudr, Jiří
Lokaj, Petr
Burša, Jiří
Pásek, Michal
author_sort Vaverka, Jiří
collection PubMed
description This study investigates the impact of reduced transmural conduction velocity (TCV) on output parameters of the human heart. In a healthy heart, the TCV contributes to synchronization of the onset of contraction in individual layers of the left ventricle (LV). However, it is unclear whether the clinically observed decrease of TCV contributes significantly to a reduction of LV contractility. The applied three-dimensional finite element model of isovolumic contraction of the human LV incorporates transmural gradients in electromechanical delay and myocyte shortening velocity and evaluates the impact of TCV reduction on pressure rise (namely, (dP/dt)(max)) and on isovolumic contraction duration (IVCD) in a healthy LV. The model outputs are further exploited in the lumped “Windkessel” model of the human cardiovascular system (based on electrohydrodynamic analogy of respective differential equations) to simulate the impact of changes of (dP/dt)(max) and IVCD on chosen systemic parameters (ejection fraction, LV power, cardiac output, and blood pressure). The simulations have shown that a 50% decrease in TCV prolongs substantially the isovolumic contraction, decelerates slightly the LV pressure rise, increases the LV energy consumption, and reduces the LV power. These negative effects increase progressively with further reduction of TCV. In conclusion, these results suggest that the pumping efficacy of the human LV decreases with lower TCV due to a higher energy consumption and lower LV power. Although the changes induced by the clinically relevant reduction of TCV are not critical for a healthy heart, they may represent an important factor limiting the heart function under disease conditions.
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spelling pubmed-71607302020-04-24 Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study Vaverka, Jiří Moudr, Jiří Lokaj, Petr Burša, Jiří Pásek, Michal Biomed Res Int Research Article This study investigates the impact of reduced transmural conduction velocity (TCV) on output parameters of the human heart. In a healthy heart, the TCV contributes to synchronization of the onset of contraction in individual layers of the left ventricle (LV). However, it is unclear whether the clinically observed decrease of TCV contributes significantly to a reduction of LV contractility. The applied three-dimensional finite element model of isovolumic contraction of the human LV incorporates transmural gradients in electromechanical delay and myocyte shortening velocity and evaluates the impact of TCV reduction on pressure rise (namely, (dP/dt)(max)) and on isovolumic contraction duration (IVCD) in a healthy LV. The model outputs are further exploited in the lumped “Windkessel” model of the human cardiovascular system (based on electrohydrodynamic analogy of respective differential equations) to simulate the impact of changes of (dP/dt)(max) and IVCD on chosen systemic parameters (ejection fraction, LV power, cardiac output, and blood pressure). The simulations have shown that a 50% decrease in TCV prolongs substantially the isovolumic contraction, decelerates slightly the LV pressure rise, increases the LV energy consumption, and reduces the LV power. These negative effects increase progressively with further reduction of TCV. In conclusion, these results suggest that the pumping efficacy of the human LV decreases with lower TCV due to a higher energy consumption and lower LV power. Although the changes induced by the clinically relevant reduction of TCV are not critical for a healthy heart, they may represent an important factor limiting the heart function under disease conditions. Hindawi 2020-04-03 /pmc/articles/PMC7160730/ /pubmed/32337235 http://dx.doi.org/10.1155/2020/2867865 Text en Copyright © 2020 Jiří Vaverka et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Vaverka, Jiří
Moudr, Jiří
Lokaj, Petr
Burša, Jiří
Pásek, Michal
Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title_full Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title_fullStr Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title_full_unstemmed Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title_short Impact of Decreased Transmural Conduction Velocity on the Function of the Human Left Ventricle: A Simulation Study
title_sort impact of decreased transmural conduction velocity on the function of the human left ventricle: a simulation study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7160730/
https://www.ncbi.nlm.nih.gov/pubmed/32337235
http://dx.doi.org/10.1155/2020/2867865
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