Mechanoelectric feedback (transduction) in heart: concepts and implications

Area of Science:

• Cardiovascular Physiology
• Cardiac Electrophysiology
• Biomedical Engineering

Background:

• Mechanoelectric feedback is an intrinsic regulatory process in normal heart function.
• This feedback modulates normal electromechanical interactions, maintaining homeostasis.
• Physiological perturbations are self-adjusting, preserving the cardiac status quo.

Purpose of the Study:

• To investigate the role of mechanoelectric feedback in cardiac pathology.
• To understand how mechanical and electrical inhomogeneities influence cardiac arrhythmias.
• To explore the mechanisms underlying mechanically induced premature ventricular contractions.

Main Methods:

• Analysis of mechanoelectric feedback loops in normal and pathological heart models.
• Investigating the impact of regional heterogeneous mechanical conditions on electrophysiology.
• Examining the interplay between mechanical/electrical inhomogeneities and arrhythmogenic processes.

Main Results:

• In cardiac pathology, particularly with inhomogeneities, mechanoelectric feedback differs significantly from normal function.
• Premature ventricular contractions can be mechanically induced, leading to instantaneous feedback.
• Interacting non-linear recovery processes of restitution and excitability compound arrhythmias.
• Mechanical and electrical inhomogeneities sustain altered excitability, arrhythmogenic current flow, and re-entry.

Conclusions:

• Mechanoelectric feedback plays a critical role in the development and sustenance of cardiac arrhythmias.
• Mechanical and electrical inhomogeneities are key factors in pathological mechanoelectric feedback.
• Understanding these interactions is crucial for developing new therapeutic strategies for cardiac arrhythmias.