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The study of border zone formation in ischemic heart using electro-chemical coupled computational model.
International Journal for Numerical Methods in Biomedical Engineering ( IF 2.2 ) Pub Date : 2020-08-28 , DOI: 10.1002/cnm.3398
Wan N Wan Ab Naim 1 , Mohd J Mohamed Mokhtarudin 2 , Einly Lim 3 , Bee T Chan 4 , Azam Ahmad Bakir 5 , Nik A Nik Mohamed 1
Affiliation  

Myocardial infarction (MI) is the most common cause of a heart failure, which occurs due to myocardial ischemia leading to left ventricular (LV) remodeling. LV remodeling particularly occurs at the ischemic area and the region surrounds it, known as the border zone. The role of the border zone in initiating LV remodeling process urges the investigation on the correlation between early border zone changes and remodeling outcome. Thus, this study aims to simulate a preliminary conceptual work of the border zone formation and evolution during onset of MI and its effect towards early LV remodeling processes by incorporating the oxygen concentration effect on the electrophysiology of an idealized three‐dimensional LV through electro‐chemical coupled mathematical model. The simulation result shows that the region of border zone, represented by the distribution of electrical conductivities, keeps expanding over time. Based on this result, the border zone is also proposed to consist of three sub‐regions, namely mildly, moderately, and seriously impaired conductivity regions, which each region categorized depending on its electrical conductivities. This division could be used as a biomarker for classification of reversible and irreversible myocardial injury and will help to identify the different risks for the survival of patient. Larger ischemic size and complete occlusion of the coronary artery can be associated with an increased risk of developing irreversible injury, in particular if the reperfusion treatment is delayed. Increased irreversible injury area can be related with cardiovascular events and will further deteriorate the LV function over time.

中文翻译:

使用电化学耦合计算模型研究缺血性心脏边界区的形成。

心肌梗塞 (MI) 是心力衰竭的最常见原因,其发生是由于心肌缺血导致左心室 (LV) 重构。LV 重塑尤其发生在缺血区及其周围的区域,称为边界区。边界区在启动 LV 重塑过程中的作用促使对早期边界区变化与重塑结果之间的相关性进行调查。因此,本研究旨在模拟 MI 发作期间边界区形成和演变的初步概念工作及其对早期 LV 重塑过程的影响,通过电化学方法结合氧浓度对理想化三维 LV 电生理的影响。耦合数学模型。仿真结果表明,边界带区域,以电导率分布为代表,随着时间的推移不断扩大。基于此结果,还提出边界区由三个子区域组成,即轻度、中度和严重电导率受损区域,每个区域根据其电导率进行分类。这种划分可作为可逆和不可逆心肌损伤分类的生物标志物,有助于识别患者生存的不同风险。较大的缺血面积和冠状动脉的完全闭塞可能与发生不可逆损伤的风险增加有关,尤其是在再灌注治疗延迟的情况下。不可逆损伤面积的增加可能与心血管事件有关,并且会随着时间的推移进一步恶化 LV 功能。
更新日期:2020-08-28
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