Determining the most significant input parameters in models of subendocardial ischaemia and their effect on ST segment epicardial potential distributions
Abstract There is considerable interest in simulating ischaemia in the ventricle and its effect on the electrocardiogram, because a better understanding of the connection between the two may lead to improvements in diagnosis of myocardial ischaemia. In this work we studied subendocardial ischaemia, in a simplified half-ellipsoidal bidomain model of a ventricle, and its effect on ST segment epicardial potential distributions (EPDs). We found that the EPD changed as the ischaemic depth increased, from a single minimum (min1) over the ischaemic region to a maximum (max) there, with min1 over the border of the region. Lastly, a second minimum (min2) developed on the opposite side of the ischaemic region, in addition to min1 and max. We replicated these results in a realistic ventricular model and showed that the min1 only case could be found for ischaemic depths of up to around 35% of the ventricular wall. In addition, we systematically examined the sensitivity of EPD parameters, such as the potentials and positions of min1, max and min2, to various inputs to the half-ellipsoidal model, such as fibre rotation angle, ischaemic depth and conductivities. We found that the EPD parameters were not sensitive to the blood or transverse bidomain conductivities and were most sensitive to either ischaemic depth and/or fibre rotation angle. This allowed us to conclude that the asynchronous development of the two minima might provide a way of distinguishing between low and high thickness subendocardial ischaemia, and that this method may well be valid despite variability in the population. Highlights We studied subendocardial ischaemia in half-ellipsoid and realistic bidomain models. We found three different epicardial patterns: min; max plus min; max plus two mins. The two mins develop asynchronously, this may help identify low and high ischaemia. We used emulators to study the sensitivity of the extrema to nine model inputs. Conductivity values have less effect than fibre rotation and ischaemic depth. Graphical abstract [DISPLAY OMISSION]
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- DOI : http://dx.doi.org/10.1016/j.compbiomed.2018.02.003
- Elsevier : 저널 > 논문
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