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Related Concept Videos

Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

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Related Experiment Video

Updated: May 8, 2026

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

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Published on: February 13, 2021

Mechanistic insight into prolonged electromechanical delay in dyssynchronous heart failure: a computational study.

Jason Constantino1, Yuxuan Hu, Albert C Lardo

  • 1Department of Biomedical Engineering and Institute of Computational Medicine, The Johns Hopkins University, Baltimore, Maryland; and.

American Journal of Physiology. Heart and Circulatory Physiology
|August 13, 2013
PubMed
Summary

In heart failure with electrical dyssynchrony, abnormal calcium handling significantly prolongs electromechanical delay (EMD). Other remodeling factors like altered structure and stiffness have minimal impact on EMD.

Keywords:
cardiac electromechanicsdyssynchronous heart failureelectromechanical modeling

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Area of Science:

  • Cardiovascular Physiology
  • Computational Biology
  • Heart Failure Pathophysiology

Background:

  • Dyssynchronous heart failure (HF) involves complex electromechanical remodeling.
  • Key factors include altered ventricular structure, abnormal calcium handling, slowed conduction, and reduced wall stiffness.
  • Electromechanical delay (EMD) is prolonged in dyssynchronous HF, but the contribution of each remodeling aspect is unclear.

Purpose of the Study:

  • To determine the individual and combined contributions of HF-induced remodeling aspects to EMD prolongation.
  • To investigate the mechanisms by which these remodeling aspects affect EMD in dyssynchronous HF.

Main Methods:

  • Utilized MRI-based electromechanical models of canine hearts.
  • Simulated left bundle branch block electrical activation in nonfailing and HF models.
  • Constructed models with varying combinations of four major HF remodeling aspects.

Main Results:

  • Deranged calcium handling was identified as the primary cause of prolonged EMD in dyssynchronous HF.
  • Altered ventricular structure, slowed conduction, and reduced wall stiffness contributed insignificantly to EMD prolongation.
  • Abnormal calcium handling slowed myofiber shortening velocity and depressed myofiber shortening/stretch rates, delaying EMD onset.

Conclusions:

  • Abnormal calcium handling is the dominant factor driving electromechanical delay in dyssynchronous heart failure.
  • Targeting calcium handling mechanisms may be crucial for managing electromechanical dyssynchrony in HF.