心率的长期变化和电力改造有助于心力衰竭中的替代物形成:一项针对患者的in silico研究
Vrishti M Phadumdeo1, Brianna L Mallare1, Thomas J Hund1,2,3
1Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio, United States.
概括
慢性心力衰竭 (CHF) 患者表现出心率变化率 (HRV) 降低,心律失常风险增加. 这项研究揭示了心率波动,比电力改造更重要的是,在CHF中显著影响心律不整的替代体.
科学领域:
- 心脏病学 心脏病学
- 计算生物学 计算生物学
- 生物物理学的生物物理.
背景情况:
- 慢性心力衰竭 (CHF) 增加了心室节律失常的风险,与细胞重塑和心率改变有关.
- 降低心率变化 (HRV) 在CHF与增加心律不整的易感性相关.
- 心率变化可以触发前节律的替代体,影响动作潜能持续时间 (APD) 和细胞内 (Ca).
研究的目的:
- 为了研究长期心率变化和CHF中电力改造对替代体形成的影响.
- 为了确定心率动态和细胞电力变化的相对贡献,以CHF的proarrhythmic替代.
主要方法:
- 分析了正常鼻节律 (NSR) 和CHF患者心电图中的RR间隔序列的统计特性.
- 利用患者特异性和合成RR间隔序列作为心脏肌细胞模型的节奏协议.
- 纳入特定于CHF的病态电气改造,用于APD和Ca处理的离散时间合地图模型.
主要成果:
- 与NSR相比,CHF患者的替代物形成更为普遍.
- 增加了自相对应时间或平均RR间隔减少了APD交替.
- 增加的RR间隔标准偏差放大了替代数大小,表明心率变化的重要作用.
结论:
- 与CHF相关的心率变化和电力改造都会影响心律不整的替代体.
- 心率变化似乎是一个比单独的电气改造更有影响力的因素在alternans形成.
- 研究结果强调了心率动态在心律不良患者心律不良风险分层中的关键作用.
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