The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study
Abstract Background The occurrence of T-wave alternans in electrocardiographic signals was recently linked to susceptibility to ventricular arrhythmias and sudden cardiac death. Thus, by detecting and comprehending the origins of T-wave alternans, it might be possible to prevent such events. Results...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-05-01
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| Series: | BioMedical Engineering OnLine |
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| Online Access: | http://link.springer.com/article/10.1186/s12938-018-0492-6 |
| _version_ | 1818943839039127552 |
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| author | D. Janusek J. Svehlikova J. Zelinka W. Weigl R. Zaczek G. Opolski M. Tysler R. Maniewski |
| author_facet | D. Janusek J. Svehlikova J. Zelinka W. Weigl R. Zaczek G. Opolski M. Tysler R. Maniewski |
| author_sort | D. Janusek |
| collection | DOAJ |
| description | Abstract Background The occurrence of T-wave alternans in electrocardiographic signals was recently linked to susceptibility to ventricular arrhythmias and sudden cardiac death. Thus, by detecting and comprehending the origins of T-wave alternans, it might be possible to prevent such events. Results Here, we simulated T-wave alternans in a computer-generated human heart model by modulating the action potential duration and amplitude during the first part of the repolarization phase. We hypothesized that changes in the intracardiac alternans patterns of action potential properties would differentially influence T-wave alternans measurements at the body surface. Specifically, changes were simulated globally in the whole left and right ventricles to simulate concordant T-wave alternans, and locally in selected regions to simulate discordant and regional discordant, hereinafter referred to as “regional”, T-wave alternans. Body surface potential maps and 12-lead electrocardiographic signals were then computed. In depth discrimination, the influence of epicardial layers on T-wave alternans development was significantly higher than that of mid-myocardial cells. Meanwhile, spatial discrimination revealed that discordant and regional action potential property changes had a higher influence on T-wave alternans amplitude than concordant changes. Notably, varying T-wave alternans sources yielded distinct body surface potential map patterns for T-wave alternans amplitude, which can be used for location of regions within hearts exhibiting impaired repolarization. The highest ability for T-wave alternans detection was achieved in lead V1. Ultimately, we proposed new parameters Vector Magnitude Alternans and Vector Angle Alternans, with higher ability for T-wave alternans detection when using multi-lead electrocardiographic signals processing than for single leads. Finally, QT alternans was found to be associated with the process of T-wave alternans generation. Conclusions The distributions of the body surface T-wave alternans amplitude have been shown to have unique patterns depending on the type of alternans (concordant, discordant or regional) and the location of the disturbance in the heart. The influence of epicardial cells on T-wave alternans development is significantly higher than that of mid-myocardial cells, among which the sub-endocardial layer exerted the highest influence. QT interval alternans is identified as a phenomenon that correlate with T-wave alternans. |
| first_indexed | 2024-12-20T07:33:42Z |
| format | Article |
| id | doaj.art-2189039e39a24a2189220221acbfa8de |
| institution | Directory Open Access Journal |
| issn | 1475-925X |
| language | English |
| last_indexed | 2024-12-20T07:33:42Z |
| publishDate | 2018-05-01 |
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| series | BioMedical Engineering OnLine |
| spelling | doaj.art-2189039e39a24a2189220221acbfa8de2022-12-21T19:48:19ZengBMCBioMedical Engineering OnLine1475-925X2018-05-0117112110.1186/s12938-018-0492-6The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation studyD. Janusek0J. Svehlikova1J. Zelinka2W. Weigl3R. Zaczek4G. Opolski5M. Tysler6R. Maniewski7Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesInstitute of Measurement Science, Slovak Academy of SciencesInstitute of Measurement Science, Slovak Academy of SciencesDepartment of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala University, Akademiska HospitalDepartment of Cardiology, Central Clinical Hospital of Medical University of WarsawDepartment of Cardiology, Central Clinical Hospital of Medical University of WarsawInstitute of Measurement Science, Slovak Academy of SciencesNalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of SciencesAbstract Background The occurrence of T-wave alternans in electrocardiographic signals was recently linked to susceptibility to ventricular arrhythmias and sudden cardiac death. Thus, by detecting and comprehending the origins of T-wave alternans, it might be possible to prevent such events. Results Here, we simulated T-wave alternans in a computer-generated human heart model by modulating the action potential duration and amplitude during the first part of the repolarization phase. We hypothesized that changes in the intracardiac alternans patterns of action potential properties would differentially influence T-wave alternans measurements at the body surface. Specifically, changes were simulated globally in the whole left and right ventricles to simulate concordant T-wave alternans, and locally in selected regions to simulate discordant and regional discordant, hereinafter referred to as “regional”, T-wave alternans. Body surface potential maps and 12-lead electrocardiographic signals were then computed. In depth discrimination, the influence of epicardial layers on T-wave alternans development was significantly higher than that of mid-myocardial cells. Meanwhile, spatial discrimination revealed that discordant and regional action potential property changes had a higher influence on T-wave alternans amplitude than concordant changes. Notably, varying T-wave alternans sources yielded distinct body surface potential map patterns for T-wave alternans amplitude, which can be used for location of regions within hearts exhibiting impaired repolarization. The highest ability for T-wave alternans detection was achieved in lead V1. Ultimately, we proposed new parameters Vector Magnitude Alternans and Vector Angle Alternans, with higher ability for T-wave alternans detection when using multi-lead electrocardiographic signals processing than for single leads. Finally, QT alternans was found to be associated with the process of T-wave alternans generation. Conclusions The distributions of the body surface T-wave alternans amplitude have been shown to have unique patterns depending on the type of alternans (concordant, discordant or regional) and the location of the disturbance in the heart. The influence of epicardial cells on T-wave alternans development is significantly higher than that of mid-myocardial cells, among which the sub-endocardial layer exerted the highest influence. QT interval alternans is identified as a phenomenon that correlate with T-wave alternans.http://link.springer.com/article/10.1186/s12938-018-0492-6T-wave alternansHeart modelECG signal simulation |
| spellingShingle | D. Janusek J. Svehlikova J. Zelinka W. Weigl R. Zaczek G. Opolski M. Tysler R. Maniewski The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study BioMedical Engineering OnLine T-wave alternans Heart model ECG signal simulation |
| title | The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study |
| title_full | The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study |
| title_fullStr | The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study |
| title_full_unstemmed | The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study |
| title_short | The roles of mid-myocardial and epicardial cells in T-wave alternans development: a simulation study |
| title_sort | roles of mid myocardial and epicardial cells in t wave alternans development a simulation study |
| topic | T-wave alternans Heart model ECG signal simulation |
| url | http://link.springer.com/article/10.1186/s12938-018-0492-6 |
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