异步心脏中的心肌输液和流量储备:从计算模型的机械洞察力
Anneloes G Munneke1, Joost Lumens1, Theo Arts1
1Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.
Journal of applied physiology (Bethesda, Md. : 1985)
|July 13, 2023
概括
心肌氧的氧气需求和供应合在异步激活过程中持续存在,例如左束分支块 (LBBB). 慢性异步激活导致壁的生长,通过调整氧气需求,使心肌 perfusion 和流量储备均化.
科学领域:
- 心血管生理学心血管生理学
- 计算生物学 计算生物学
- 医疗成像医学成像
背景情况:
- 心肌氧的氧气需求和供应之间的关系是很好的建立,但在异步激活,如在左捆分支区块 (LBBB) 期间辩论.
- 慢性异步激活对心脏壁生长的影响及其对心肌输液分布的影响尚未完全理解.
研究的目的:
- 通过计算模型,研究在异步激活下心肌氧氧气供需合的持久性.
- 为了确定由于慢性异步激活的心脏壁生长是否可以解释心肌输液的变化.
主要方法:
- 开发了一个结合心脏力学和 perfusion 的建模框架,结合了冠状动脉自调节.
- 模拟的区域冠状动脉流量基于从纤维应力-张力估计的需求.
- 适应左心室壁段体积,以在慢性异步激活下实现每组织重量的均氧气需求.
主要成果:
- 早期激活地区的氧气需求和供应减少;晚期激活地区的氧气供应增加.
- 区域性高血压流仍然不受影响,但随着氧气需求的增加和壁厚的减少,心肌流量储备下降.
- 在LBBB中,septal hypoperfusion似乎是对减少氧气需求的自我调节反应.
结论:
- 氧气需求驱动的改造解释了非对称的缩和心肌 perfusion 和流量储备的同质化.
- 在异步激活过程中,心肌输液和流量储备的不一致性是由异步,高和成像模式解释的.
- 该模型提供了关于急性和慢性异步激活期间休息和高血压心肌流的见解.
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