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Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study

Myocardial fibrosis is an integral component of most forms of heart failure. Clinical and computational studies have reported that spatial fibrosis pattern and fibrosis amount play a significant role in ventricular arrhythmogenicity. This study investigated the effect of the spatial distribution of...

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Autores principales: Heikhmakhtiar, Aulia Khamas, Tekle, Abrha Abebe, Lim, Ki Moo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209383/
https://www.ncbi.nlm.nih.gov/pubmed/34149441
http://dx.doi.org/10.3389/fphys.2021.644473
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author Heikhmakhtiar, Aulia Khamas
Tekle, Abrha Abebe
Lim, Ki Moo
author_facet Heikhmakhtiar, Aulia Khamas
Tekle, Abrha Abebe
Lim, Ki Moo
author_sort Heikhmakhtiar, Aulia Khamas
collection PubMed
description Myocardial fibrosis is an integral component of most forms of heart failure. Clinical and computational studies have reported that spatial fibrosis pattern and fibrosis amount play a significant role in ventricular arrhythmogenicity. This study investigated the effect of the spatial distribution of fibrosis and fibrosis amount on the electrophysiology and mechanical performance of the human ventricles. Seventy-five fibrosis distributions comprising diffuse, patchy, and compact fibrosis types that contain 10–50% fibrosis amount were generated. The spatial fibrosis distribution was quantified using the fibrosis entropy (FE) metric. Electrical simulations under reentry conditions induced using the S1–S2 protocol were conducted to investigate the fibrosis arrhythmogenicity. We also performed mechanical simulations to examine the influence of the fibrosis amount and the spatial distribution of fibrosis on the pumping efficacy of the LV. We observed that the mean FE of the compact type is the largest among the three types. The electrical simulation results revealed that the ventricular arrhythmogenicity of diffuse fibrosis depends on the fibrosis amount and marginally on the spatial distribution of fibrosis. Meanwhile, the ventricular arrhythmogenicity of the compact and patchy fibrosis pattern is more reliant on the spatial distribution of fibrosis than on the fibrosis amount. The average number of phase singularities (PSs) in the compact fibrosis pattern was the highest among the three patterns of fibrosis. The diffuse type of fibrosis has the lowest average number of PSs than that in the patchy and compact fibrosis. The reduction in the stroke volume (SV) showed high influence from the electrical instabilities induced by the fibrosis amount and pattern. The compact fibrosis exhibited the lowest SV among the three patterns except in the 40% fibrosis amount. In conclusion, the fibrosis pattern is as crucial as the fibrosis amount for sustaining and aggravating ventricular arrhythmogenesis.
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spelling pubmed-82093832021-06-18 Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study Heikhmakhtiar, Aulia Khamas Tekle, Abrha Abebe Lim, Ki Moo Front Physiol Physiology Myocardial fibrosis is an integral component of most forms of heart failure. Clinical and computational studies have reported that spatial fibrosis pattern and fibrosis amount play a significant role in ventricular arrhythmogenicity. This study investigated the effect of the spatial distribution of fibrosis and fibrosis amount on the electrophysiology and mechanical performance of the human ventricles. Seventy-five fibrosis distributions comprising diffuse, patchy, and compact fibrosis types that contain 10–50% fibrosis amount were generated. The spatial fibrosis distribution was quantified using the fibrosis entropy (FE) metric. Electrical simulations under reentry conditions induced using the S1–S2 protocol were conducted to investigate the fibrosis arrhythmogenicity. We also performed mechanical simulations to examine the influence of the fibrosis amount and the spatial distribution of fibrosis on the pumping efficacy of the LV. We observed that the mean FE of the compact type is the largest among the three types. The electrical simulation results revealed that the ventricular arrhythmogenicity of diffuse fibrosis depends on the fibrosis amount and marginally on the spatial distribution of fibrosis. Meanwhile, the ventricular arrhythmogenicity of the compact and patchy fibrosis pattern is more reliant on the spatial distribution of fibrosis than on the fibrosis amount. The average number of phase singularities (PSs) in the compact fibrosis pattern was the highest among the three patterns of fibrosis. The diffuse type of fibrosis has the lowest average number of PSs than that in the patchy and compact fibrosis. The reduction in the stroke volume (SV) showed high influence from the electrical instabilities induced by the fibrosis amount and pattern. The compact fibrosis exhibited the lowest SV among the three patterns except in the 40% fibrosis amount. In conclusion, the fibrosis pattern is as crucial as the fibrosis amount for sustaining and aggravating ventricular arrhythmogenesis. Frontiers Media S.A. 2021-06-03 /pmc/articles/PMC8209383/ /pubmed/34149441 http://dx.doi.org/10.3389/fphys.2021.644473 Text en Copyright © 2021 Heikhmakhtiar, Tekle and Lim. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Heikhmakhtiar, Aulia Khamas
Tekle, Abrha Abebe
Lim, Ki Moo
Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title_full Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title_fullStr Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title_full_unstemmed Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title_short Influence of Fibrosis Amount and Patterns on Ventricular Arrhythmogenesis and Pumping Efficacy: Computational Study
title_sort influence of fibrosis amount and patterns on ventricular arrhythmogenesis and pumping efficacy: computational study
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209383/
https://www.ncbi.nlm.nih.gov/pubmed/34149441
http://dx.doi.org/10.3389/fphys.2021.644473
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