Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.
Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.
Comput Methods Biomech Biomed Engin. 2024 Jun;27(8):1011-1027. doi: 10.1080/10255842.2023.2222203. Epub 2023 Jun 14.
Single ventricle patients, including those with hypoplastic left heart syndrome (HLHS), typically undergo three palliative heart surgeries culminating in the Fontan procedure. HLHS is associated with high rates of morbidity and mortality, and many patients develop arrhythmias, electrical dyssynchrony, and eventually ventricular failure. However, the correlation between ventricular enlargement and electrical dysfunction in HLHS physiology remains poorly understood. Here we characterize the relationship between growth and electrophysiology in HLHS using computational modeling. We integrate a personalized finite element model, a volumetric growth model, and a personalized electrophysiology model to perform controlled in silico experiments. We show that right ventricle enlargement negatively affects QRS duration and interventricular dyssynchrony. Conversely, left ventricle enlargement can partially compensate for this dyssynchrony. These findings have potential implications on our understanding of the origins of electrical dyssynchrony and, ultimately, the treatment of HLHS patients.
单心室患者，包括左心发育不全综合征（HLHS）患者，通常需要接受三次姑息性心脏手术，最终进行 Fontan 手术。HLHS 与高发病率和死亡率相关，许多患者会出现心律失常、电不同步，最终发展为心力衰竭。然而，HLHS 生理中心室扩张与电功能障碍之间的相关性仍知之甚少。在这里，我们使用计算模型来描述 HLHS 中的生长和电生理学之间的关系。我们整合了个性化有限元模型、体积生长模型和个性化电生理学模型来进行受控的计算机模拟实验。我们表明，右心室扩张会导致 QRS 持续时间延长和室间不同步。相反，左心室扩张可以部分补偿这种不同步。这些发现对我们理解电不同步的起源以及最终治疗 HLHS 患者具有潜在意义。
