当前位置： SCI文献检索 > HEART RHYTHM期刊下所有文献 > Optimizing cardiac resynchronization therapy to minimize ATP consumption heterogeneity throughout the left ventricle: a simulation analysis using a canine heart failure model.

Optimizing cardiac resynchronization therapy to minimize ATP consumption heterogeneity throughout the left ventricle: a simulation analysis using a canine heart failure model.

Abstract：

BACKGROUND:Cardiac resynchronization therapy (CRT) has been demonstrated to lead to restoration of oxygen consumption homogeneity throughout the left ventricle (LV), which is important for long-term reverse remodeling of the ventricles. However, research has focused exclusively on identifying the LV pacing sites that led to acute hemodynamic improvements. It remains unclear whether there exist LV pacing sites that could both improve the hemodynamics and result in ATP consumption homogeneity throughout the LV, thus maximizing both CRT short-term and long-term benefits. OBJECTIVE:The purpose of this study was to demonstrate the feasibility of optimizing CRT pacing locations to achieve maximal improvement in both ATPCTHI (an ATP consumption heterogeneity index) and stroke work. METHODS:We used an magnetic resonance image-based electromechanical model of the dyssynchronous heart failure (DHF) canine ventricles. ATPCTHI and stroke work improvement were determined for each of 34 CRT pacing sites evenly spaced over the LV epicardium. RESULTS:Results demonstrated the feasibility of determining the optimal LV pacing site that achieves simultaneous maximum improvements in ATPCTHI and stroke work. The optimal LV CRT pacing sites in the DHF canine ventricles were located midway between apex and base. The improvement in ATPCTHI decreased more rapidly with the distance from the optimal sites compared to stroke work improvement. CRT from the optimal sites homogenized ATP consumption by increasing septal ATP consumption and decreasing that of the lateral wall. CONCLUSION:Simulation results using a canine heart failure model demonstrated that CRT can be optimized to achieve improvements in both ATPCTHI and stroke work.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Hu Y,Gurev V,Constantino J,Trayanova N

doi

10.1016/j.hrthm.2014.03.021

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

1063-9

issue

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(14)00302-6

journal_volume

pub_type

杂志文章

在线工具

Optimizing cardiac resynchronization therapy to minimize ATP consumption heterogeneity throughout the left ventricle: a simulation analysis using a canine heart failure model.