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Inter-individual Differences in Cell Composition across the Ventricular Wall May Explain Variability in ECG Response to Serum Potassium and Calcium Variations

文献类型： 会议论文

第一作者： Hassaan A Bukhari

作者： Hassaan A Bukhari 1 ; Carlos Sánchez 2 ; Pablo Laguna 2 ; Mark Potse 3 ; Esther Pueyo 2 ;

作者机构： 1.I3A, University of Zaragoza, Zaragoza, Spain|Univ. Bordeaux, IMB, Talence, France|Carmen team, Inria Bordeaux - Sud-Ouest|CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain

2.I3A, University of Zaragoza, Zaragoza, Spain|CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Spain

3.Univ. Bordeaux, IMB, Talence, France|Carmen team, Inria Bordeaux - Sud-Ouest

关键词： Torso;Sensitivity;Computational modeling;Calcium;Electrocardiography;Electrolytes;Data models

会议名称： Computing in Cardiology Conference

主办单位：

页码： 1-4

摘要： Non-invasive monitoring of serum potassium $([mathrm{K}^{+}])$ and calcium $[text{Ca}^{2+}]$ concentration can help to prevent arrhythmia in kidney patients. Current electrocardiogram (ECG) markers, including the T wave width $(T_{mathrm{w}})$ and its time-warped temporal morphological variability $(d_{mathrm{w}}^{mathrm{U}})$, correlate significantly with $[mathrm{K}^{+}]$ and $[text{Ca}^{2+}]$ but these relations vary strongly between patients. We hypothesized that inter-individual differences in cell type distribution across the ventricular wall can explain this variability. We computed $T_{mathrm{w}}$ and $d_{mathrm{w}}^{mathrm{U}}$ in simulated ECGs from a human heart-torso model at different proportions of endo-, mid-, and epicardial cells, while varying $[mathrm{K}^{+}]$ (3 to 6.2 mM) and $[text{Ca}^{2+}] (1.4$ to 3.2 mM). Electrical activity was simulated with a reaction-diffusion model with modified Ten Tusscher-Panfilov dynamics. Results were compared to data from 29 patients. $T_{mathrm{w}}$ and $d_{mathrm{w}}^{mathrm{U}}$ correlated strongly with $[mathrm{K}^{+}]$ (absolute median Pearson coefficient $r=0.70$ to 0.93) and $[text{Ca}^{2+}] (r=0.69$ to 0.86) in simulations and in patients. Different cell type distributions reproduced inter-patient variability, with the same sign and magnitude of $r$. In conclusion, the inter-patient variability in the relation between serum electrolytes and their ECG markers can indeed be explained by inter-individual differences in cell type distribution across the ventricular wall.

分类号： tp3

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