Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA.
Am J Physiol Heart Circ Physiol. 2011 Aug;301(2):H279-86. doi: 10.1152/ajpheart.00324.2011. Epub 2011 May 13.
Computational modeling has traditionally played an important role in dissecting the mechanisms for cardiac dysfunction. Ventricular electromechanical models, likely the most sophisticated virtual organs to date, integrate detailed information across the spatial scales of cardiac electrophysiology and mechanics and are capable of capturing the emergent behavior and the interaction between electrical activation and mechanical contraction of the heart. The goal of this review is to provide an overview of the latest advancements in multiscale electromechanical modeling of the ventricles. We first detail the general framework of multiscale ventricular electromechanical modeling and describe the state of the art in computational techniques and experimental validation approaches. The powerful utility of ventricular electromechanical models in providing a better understanding of cardiac function is then demonstrated by reviewing the latest insights obtained by these models, focusing primarily on the mechanisms by which mechanoelectric coupling contributes to ventricular arrythmogenesis, the relationship between electrical activation and mechanical contraction in the normal heart, and the mechanisms of mechanical dyssynchrony and resynchronization in the failing heart. Computational modeling of cardiac electromechanics will continue to complement basic science research and clinical cardiology and holds promise to become an important clinical tool aiding the diagnosis and treatment of cardiac disease.
计算建模在剖析心脏功能障碍的机制方面一直发挥着重要作用。心室机电模型可能是迄今为止最复杂的虚拟器官,它整合了心脏电生理学和力学的空间尺度上的详细信息,能够捕捉心脏电活动和机械收缩之间的涌现行为和相互作用。本综述的目的是概述心室多尺度机电建模的最新进展。我们首先详细介绍了多尺度心室机电建模的一般框架,并描述了计算技术和实验验证方法的最新进展。然后,通过回顾这些模型所获得的最新见解,展示了心室机电模型在更好地理解心脏功能方面的强大功能,主要集中在心电机械耦合并导致心室心律失常的机制、正常心脏中电活动和机械收缩之间的关系,以及心力衰竭中心脏机械失同步和再同步的机制。心脏电机械的计算建模将继续补充基础科学研究和临床心脏病学,并有望成为一种重要的临床工具,辅助心脏疾病的诊断和治疗。