心肌梗死和缺血对心室组织兴奋波传播的联合影响

Cuiping Liang, Kuanquan Wang, Qince Li, Henggui Zhang
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摘要

目的:既往研究表明,心肌组织的梗死和缺血与房性和室性快速心律失常的发生率密切相关。然而,到目前为止,心肌梗死和缺血在心律失常发生中的联合作用尚未完全清楚。因此,本研究旨在探讨心肌梗死和缺血共存对激发波传播的影响。方法:根据实验数据模拟大鼠缺血状态下的电生理重构,并将其纳入TP06模型。利用所构建的二维和三维模型,模拟了正常、三级心肌缺血和心肌梗死五种不同状态下心室组织的兴奋波传导。结果:模拟结果表明,在正常、梗死和缺血情况下,传导速度和转子轨迹不同。此外,在二维和三维模型中观察心肌梗死伴缺血状态的再入波。结论:模拟结果表明心肌梗死与缺血区域的相互作用增加了心室组织的空间电异质性,增强了致心律失常的作用。
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The Combined Effect of Myocardial Infarction and Ischemia on Excitation Wave Propagation in Ventricular Tissue
Aims: Previous studies have shown that the infarction and ischemia of cardiac tissue are strongly correlated with incidence of atrial and ventricular tachyarrhythmias. However, so far the combined effect of myocardial infarction and ischemia on the genesis of cardiac arrhythmias has not been fully understood. Therefore, this study aimed to investigate how the coexistence of myocardial infarction and ischemia alters excitation wave propagation.Methods: The electrophysiology remodeling under ischemia condition was mimicked based on experimental data and incorporated into TP06 model. Using the constructed 2D and 3D models, we simulated the excitation wave conduction in ventricular tissue under five different conditions: normal, myocardial ischemia under three levels, and myocardial infarction conditions.Results: Simulation results showed that the conduction velocity and rotor tracks are different in the normal, infarcted and ischemic conditions. In addition, reentry waves are observed in myocardial infarction with the ischemic condition in 2D and 3D models.Conclusion: Simulation results demonstrate that the coaction of myocardial infarction and ischemia areas increases spatial electrical heterogeneity of ventricular tissue, which may enhance the pro-arrhythmogenic effect.
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