Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Ventricular Electromechanical Characteristics by Lesions in Sudden Myocardial Infraction: Computer Simulation Study

급성 심근경색 병변에 따른 심실의 전기 역학적 특성 분석: 컴퓨터 시뮬레이션 연구

  • Baek, Dong Geun (Dept. of Medical IT Convergence Engineering, Kumoh National Institute of Technology) ;
  • Jeong, Da Un (Dept. of IT convergence Engineering, Kumoh National Institute of Technology) ;
  • Lim, Ki Moo (Dept. of IT convergence Engineering, Kumoh National Institute of Technology)
  • 백동근 (금오공과대학교 메디컬IT융합공학과) ;
  • 정다운 (금오공과대학교 IT융복합공학과) ;
  • 임기무 (금오공과대학교 IT융복합공학과)
  • Received : 2017.11.15
  • Accepted : 2017.12.04
  • Published : 2017.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Myocardial infarction is a disease caused by stenosis of the coronary arteries. The high risk of sudden cardiac death due to myocardial infarction has triggered related researches that have been actively studied so far. However, these studies focused on the clinical results, which are mainly based on observations of symptoms due to infarction through electrocardiograms. Therefore, in this study, we tried to analyze the behavior of heart according to the position and volume of infarction lesion through the computer simulation study using three dimensional ventricular models. In order to implement infarction, commercial software was used to simulate cell necrosis due to blockage of a specific coronary. In addition, the conduction block due to infarction was mimicked by reducing the electrical conduction in the infarcted area, which was 100 times less than the electrical conduction of the whole ventricular lattice implemented by the finite element analysis method. Thus, this study classified the infarcted cases into the upper, middle, lower, and apex according to lattice data of eight different infraction areas. In other words, we assumed that myocardial infarction would have inherent electro-dynamic characteristics depending on the location and extent, and analyzed the ventricular electromechanical responses for infarction lesions using a three dimensional cardiac physiome model. The results showed that the volume of infarction did not directly affect the cardiac responses, but the location of the infarction lesions could influence the ventricular pumping efficiency. These suggest that the occlusion of specific coronary arteries may have a fatal effect on the decline in ventricular performance. In conclusion, although location of myocardial infarction lesions is considered to be an important variable to be considered clinically rather than lesion size, quantitative predictions should be made more in the future considering physiological factors such as lesion location and direction of myocardial fiber at that location.

Keywords

References

  1. M.J. Davies and A. Thomas "Thrombosis and Acute Coronary- Artery Lesions in Sudden Cardiac Ischemic Death," New England Journal of Medicine vol. 310, no. 18, pp. 1137- 1140. 1984. https://doi.org/10.1056/NEJM198405033101801
  2. P. Laine, M. Kaartinen, A. Penttilä, P. Panula, T. Paavonen and P.T. Kovanen, "Association Between Myocardial Infarction and the Mast Cells in the Adventitia of the Infarct-Related Coronary Artery," Circulation, vol. 99, no. 3, pp. 361-369. 1999. https://doi.org/10.1161/01.CIR.99.3.361
  3. P.R. MAROKO, J.K. KJEKSHUS, B.E. SOBEL, T. WATANABE, J.W. COVELL, J. ROSS and E. BRAUNWALD, "Factors Influencing Infarct Size Following Experimental Coronary Artery Occlusions," Circulation, vol. 43, no. 1, pp. 67-82. 1971. https://doi.org/10.1161/01.CIR.43.1.67
  4. K.M. ROSEN, H.S. LOEB, R. CHUQUIMIA, M.Z. SINNO, S.H. RAHIMTOOLA and R.M. GUNNAR, "Site of Heart Block in Acute Myocardial Infarction," Circulation, vol. 42, no. 5, pp. 925-933. 1970. https://doi.org/10.1161/01.CIR.42.5.925
  5. T. Anzai and S. Ogawa, "Key Points and Pitfalls in Electrocardiographic Diagnosis of Acute Myocardial Infarction," JAPAN MEDICAL ASSOCIATION JOURNAL, vol. 45, no. 4, pp. 135-142. 2002.
  6. P.H. Jeong, J.Y. Lee, B.S. Yoo, K.Y. Shim, S.H. Lee, S.O. Hwang, J.H. Yoon, K.H. Choe and K.S. Park, "Acute myocardial infarction in the young adult," Korean Circulation Journal, vol. 28, no. 1, pp. 8-12. 1998. https://doi.org/10.4070/kcj.1998.28.1.8
  7. V. Pasceri, D. Cianflone, M.L. Finocchiaro, F. Crea and A. Maseri, "Relation between myocardial infarction site and pain location in Q-wave acute myocardial infarction," The American journal of cardiology, vol. 75, no. 4, pp. 224-227. 1995. https://doi.org/10.1016/0002-9149(95)80024-M
  8. K.H.W.J. Ten Tusscher and A.V. Panfilov, "Alternans and spiral breakup in a human ventricular tissue model," American Journal of Physiology - Heart and Circulatory Physiology, vol. 291, no. 3, pp. H1088-H1100. 2006. https://doi.org/10.1152/ajpheart.00109.2006
  9. J.J. Rice, F. Wang, D.M. Bers and P.P. de Tombe, "Approximate Model of Cooperative Activation and Crossbridge Cycling in Cardiac Muscle Using Ordinary Differential Equations," Biophysical Journal, vol. 95, no. 5, pp. 2368- 2390. 2008. https://doi.org/10.1529/biophysj.107.119487