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Effects of cardiac growth on electrical dyssynchrony in the single ventricle patient

O Z Tikenoğulları1, M Peirlinck2, H Chubb3

  • 1Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.

Computer Methods in Biomechanics and Biomedical Engineering
|June 14, 2023
PubMed

Insights

Computational modeling reveals that right ventricle enlargement in hypoplastic left heart syndrome (HLHS) patients worsens electrical dysfunction. However, left ventricle enlargement may offer some compensatory benefits for heart rhythm.

Area of Science:

  • Cardiovascular Physiology
  • Computational Biology
  • Pediatric Cardiology

Background:

  • Hypoplastic left heart syndrome (HLHS) necessitates complex surgical palliation, often leading to significant morbidity.
  • Patients with single ventricle physiology frequently develop arrhythmias and ventricular dysfunction post-surgery.
  • The interplay between ventricular growth and electrical abnormalities in HLHS remains unclear.

Purpose of the Study:

  • To computationally investigate the relationship between ventricular enlargement and electrical dysfunction in HLHS.
  • To elucidate how cardiac growth impacts electrophysiology in single ventricle hearts.
  • To identify potential mechanisms underlying electrical dyssynchrony in HLHS patients.

Main Methods:

  • Integration of personalized finite element, volumetric growth, and electrophysiology models.
  • In silico experiments to simulate ventricular growth and its electrophysiological consequences.
  • Analysis of QRS duration and interventricular dyssynchrony under simulated growth conditions.

Main Results:

  • Right ventricle enlargement was found to significantly increase QRS duration.
  • Enlargement of the right ventricle exacerbates interventricular electrical dyssynchrony.
  • Left ventricle enlargement demonstrated a partial compensatory effect on interventricular dyssynchrony.

Conclusions:

  • Ventricular growth patterns significantly influence electrical function in HLHS.
  • Right ventricle enlargement contributes to electrical dyssynchrony, while left ventricle enlargement may mitigate it.
  • These findings offer insights into the origins of electrical dysfunction and potential therapeutic targets for HLHS.

Keywords:
Hypoplastic left heart syndromecardiac electrophysiologycongenital heart diseasedyssynchronygrowth and remodeling

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