基于显微CT和连续组织切片的哺乳动物心脏模型中心脏折返的动力学
Dynamics of cardiac re-entry in micro-CT and serial histological sections based models of mammalian hearts
摘要：
自组织异常同步的心脏折返机制是危险的心律失常和致命性纤颤的基础。耗散涡流理论、实验研究和解剖学上逼真的计算机模拟的最新进展阐明了心脏折返与心脏中精细解剖特征的相互作用以及解剖学诱导的漂移的作用。心脏的解剖学和结构各向异性在一个物种内是一致的，这一事实表明它可能对心脏折返的自发漂移产生功能影响。解剖学诱导漂移的比较研究可用于预测房性心律失常的演变，并改进低压除颤方案和消融策略。在这里，在基于大鼠肺静脉壁的微型CT模型中，以及在基于高分辨率连续组织切片的绵羊心房模型中，我们证明了心脏几何形状和各向异性对心脏再入解剖结构引起的漂移的影响，其钉扎到层中厚度的波动。将绵羊心房和大鼠肺静脉壁的数据集纳入BeatBox高性能计算仿真环境。在心脏组织的空间均质单域模型中的规定位置处启动重新进入。激发由FitzHugh-Nagumo动力学描述。在计算机模拟模型中，各向同性和各向异性传导显示了特定的解剖结构效应以及心脏解剖结构和各向异性之间的相互作用。主要目的是证明物种心脏几何形状和各向异性对心脏再入解剖结构诱导的漂移的功能作用。在大鼠肺静脉壁与~90度透壁纤维旋转的情况下，它示出了PV壁几何形状和各向异性的联合效应将平面激发波变成钉扎到壁中的厚度的小波动的再进入。
英文摘要：
Cardiac re-entry regime of self-organised abnormal synchronisation underlie dangerous arrhythmias and fatal fibrillation. Recent advances in the theory of dissipative vortices, experimental studies, and anatomically realistic computer simulations, elucidated the role of cardiac re-entry interaction with fine anatomical features in the heart, and anatomy induced drift. The fact that anatomy and structural anisotropy of the heart is consistent within a species suggested its possible functional effect on spontaneous drift of cardiac re-entry. A comparative study of the anatomy induced drift could be used in order to predict evolution of atrial arrhythmia, and improve low-voltage defibrillation protocols and ablation strategies. Here, in micro-CT based model of rat pulmonary vein wall, and in sheep atria models based on high resolution serial histological sections, we demonstrate effects of heart geometry and anisotropy on cardiac re-entry anatomy induced drift, its pinning to fluctuations of thickness in the layer. The data sets of sheep atria and rat pulmonary vein wall are incorporated into the BeatBox High Performance Computing simulation environment. Re-entry is initiated at prescribed locations in the spatially homogeneous mono-domain models of cardiac tissue. Excitation is described by FitzHugh-Nagumo kinetics. In the in-silico models, isotropic and anisotropic conduction show specific anatomy effects and the interplay between anatomy and anisotropy of the heart. The main objectives are to demonstrate the functional role of the species hearts geometry and anisotropy on cardiac re-entry anatomy induced drift. In case of the rat pulmonary vein wall with ~90 degree transmural fibre rotation, it is shown that the joint effect of the PV wall geometry and anisotropy turns a plane excitation wave into a re-entry pinned to a small fluctuation of thickness in the wall.
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