Successful Cardiac Resynchronization Therapy Reduces Negative Septal Work in Patient-Specific Models of
Amanda Craine1, Adarsh Krishnamurthy1,2, Christopher T Villongco1
1Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA.
Biorxiv : the Preprint Server for Biology
|May 27, 2024
Summary
Cardiac resynchronization therapy (CRT) improves heart function in dyssynchronous heart failure by enhancing myocardial work, particularly in early-activated regions, promoting reverse ventricular remodeling.
Area of Science:
- Cardiology
- Biomedical Engineering
- Computational Biology
Background:
- Dyssynchronous heart failure (DHF) involves non-homogeneous myocardial work due to conduction abnormalities.
- Cardiac resynchronization therapy (CRT) improves DHF outcomes by synchronizing ventricular contractions.
Approach:
- Utilized patient-specific 3D computational models to analyze regional myocardial work before and after CRT.
- Investigated streamlined computational methods using ventricular pressure and surface area changes for clinical translatability.
Key Points:
- CRT enhanced global myocardial work efficiency, benefiting non-responders.
- Reverse ventricular remodeling correlated with baseline work heterogeneity but not overall heterogeneity reduction.
- Decreases in negative myocardial work in early-activated regions best explained remodeling variations post-CRT.
Conclusions:
- CRT promotes reverse ventricular remodeling in DHF by increasing work in early-activated regions.
- Streamlined computational approaches can accurately estimate regional myocardial work changes after CRT.
