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Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model

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Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model. / Niederer, Steven Alexander; Lamata de la Orden, Pablo; Plank, Gernot; Chinchapatnam, Phani; Ginks, Matthew; Rhode, Kawal; Rinaldi, Christopher Aldo; Razavi, Reza; Smith, Nicolas Peter.

In: PL o S One , Vol. 7, No. 8, e43504, 28.08.2012, p. -.

Research output: Contribution to journalArticle

Harvard

Niederer, SA, Lamata de la Orden, P, Plank, G, Chinchapatnam, P, Ginks, M, Rhode, K, Rinaldi, CA, Razavi, R & Smith, NP 2012, 'Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model' PL o S One , vol 7, no. 8, e43504, pp. -. DOI: 10.1371/journal.pone.0043504

APA

Niederer, S. A., Lamata de la Orden, P., Plank, G., Chinchapatnam, P., Ginks, M., Rhode, K., ... Smith, N. P. (2012). Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model. PL o S One , 7(8), -. [e43504]. DOI: 10.1371/journal.pone.0043504

Vancouver

Niederer SA, Lamata de la Orden P, Plank G, Chinchapatnam P, Ginks M, Rhode K et al. Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model. PL o S One . 2012 Aug 28;7(8):-. e43504. Available from, DOI: 10.1371/journal.pone.0043504

Author

Niederer, Steven Alexander ; Lamata de la Orden, Pablo ; Plank, Gernot ; Chinchapatnam, Phani ; Ginks, Matthew ; Rhode, Kawal ; Rinaldi, Christopher Aldo ; Razavi, Reza ; Smith, Nicolas Peter. / Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model. In: PL o S One . 2012 ; Vol. 7, No. 8. pp. -

Bibtex Download

@article{db1c8f4aa8fc49ef85e4c68c7ed0afe7,
title = "Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model",
abstract = "Regulation of regional work is essential for efficient cardiac function. In patients with heart failure and electrical dysfunction such as left branch bundle block regional work is often depressed in the septum. Following cardiac resynchronisation therapy (CRT) this heterogeneous distribution of work can be rebalanced by altering the pattern of electrical activation. To investigate the changes in regional work in these patients and the mechanisms underpinning the improved function following CRT we have developed a personalised computational model. Simulations of electromechanical cardiac function in the model estimate the regional stress, strain and work pre- and post-CRT. These simulations predict that the increase in observed work performed by the septum following CRT is not due to an increase in the volume of myocardial tissue recruited during contraction but rather that the volume of recruited myocardium remains the same and the average peak work rate per unit volume increases. These increases in the peak average rate of work is is attributed to slower and more effective contraction in the septum, as opposed to a change in active tension. Model results predict that this improved septal work rate following CRT is a result of resistance to septal contraction provided by the LV free wall. This resistance results in septal shortening over a longer period which, in turn, allows the septum to contract while generating higher levels of active tension to produce a higher work rate.",
keywords = "Ventricular Remodeling, Heart Failure, Computer Simulation, Humans, Electrophysiology, Bundle-Branch Block, Cardiac Pacing, Artificial, Oxygen Consumption, Stress, Mechanical, Cardiac Resynchronization Therapy, Middle Aged, Female, Heart Ventricles, Models, Anatomic",
author = "Niederer, {Steven Alexander} and {Lamata de la Orden}, Pablo and Gernot Plank and Phani Chinchapatnam and Matthew Ginks and Kawal Rhode and Rinaldi, {Christopher Aldo} and Reza Razavi and Smith, {Nicolas Peter}",
year = "2012",
month = "8",
day = "28",
doi = "10.1371/journal.pone.0043504",
language = "English",
volume = "7",
pages = "--",
journal = "PL o S One",
issn = "1932-6203",
publisher = "PUBLIC LIBRARY SCIENCE",
number = "8",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Analyses of the redistribution of work following cardiac resynchronisation therapy in a patient specific model

AU - Niederer,Steven Alexander

AU - Lamata de la Orden,Pablo

AU - Plank,Gernot

AU - Chinchapatnam,Phani

AU - Ginks,Matthew

AU - Rhode,Kawal

AU - Rinaldi,Christopher Aldo

AU - Razavi,Reza

AU - Smith,Nicolas Peter

PY - 2012/8/28

Y1 - 2012/8/28

N2 - Regulation of regional work is essential for efficient cardiac function. In patients with heart failure and electrical dysfunction such as left branch bundle block regional work is often depressed in the septum. Following cardiac resynchronisation therapy (CRT) this heterogeneous distribution of work can be rebalanced by altering the pattern of electrical activation. To investigate the changes in regional work in these patients and the mechanisms underpinning the improved function following CRT we have developed a personalised computational model. Simulations of electromechanical cardiac function in the model estimate the regional stress, strain and work pre- and post-CRT. These simulations predict that the increase in observed work performed by the septum following CRT is not due to an increase in the volume of myocardial tissue recruited during contraction but rather that the volume of recruited myocardium remains the same and the average peak work rate per unit volume increases. These increases in the peak average rate of work is is attributed to slower and more effective contraction in the septum, as opposed to a change in active tension. Model results predict that this improved septal work rate following CRT is a result of resistance to septal contraction provided by the LV free wall. This resistance results in septal shortening over a longer period which, in turn, allows the septum to contract while generating higher levels of active tension to produce a higher work rate.

AB - Regulation of regional work is essential for efficient cardiac function. In patients with heart failure and electrical dysfunction such as left branch bundle block regional work is often depressed in the septum. Following cardiac resynchronisation therapy (CRT) this heterogeneous distribution of work can be rebalanced by altering the pattern of electrical activation. To investigate the changes in regional work in these patients and the mechanisms underpinning the improved function following CRT we have developed a personalised computational model. Simulations of electromechanical cardiac function in the model estimate the regional stress, strain and work pre- and post-CRT. These simulations predict that the increase in observed work performed by the septum following CRT is not due to an increase in the volume of myocardial tissue recruited during contraction but rather that the volume of recruited myocardium remains the same and the average peak work rate per unit volume increases. These increases in the peak average rate of work is is attributed to slower and more effective contraction in the septum, as opposed to a change in active tension. Model results predict that this improved septal work rate following CRT is a result of resistance to septal contraction provided by the LV free wall. This resistance results in septal shortening over a longer period which, in turn, allows the septum to contract while generating higher levels of active tension to produce a higher work rate.

KW - Ventricular Remodeling

KW - Heart Failure

KW - Computer Simulation

KW - Humans

KW - Electrophysiology

KW - Bundle-Branch Block

KW - Cardiac Pacing, Artificial

KW - Oxygen Consumption

KW - Stress, Mechanical

KW - Cardiac Resynchronization Therapy

KW - Middle Aged

KW - Female

KW - Heart Ventricles

KW - Models, Anatomic

U2 - 10.1371/journal.pone.0043504

DO - 10.1371/journal.pone.0043504

M3 - Article

VL - 7

SP - -

JO - PL o S One

T2 - PL o S One

JF - PL o S One

SN - 1932-6203

IS - 8

M1 - e43504

ER -

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