集成心脏-躯干机电模型用于考虑心肌变形的电生理输出模拟
An integrated heart-torso electromechanical model for the simulation of electrophysiogical outputs accounting for myocardial deformation
AI总结：
提出耦合心脏机电与躯干电生理传播的模型，考虑心肌变形对心电图和体表电位图的影响，在真实三维几何上验证，显示收缩在病理条件下影响显著。
摘要：
在生成诸如心电图（ECGs）和体表电位图（BSPMs）等计算机模拟临床电生理输出时，数学模型一直依赖于单一物理过程，即心脏电生理（EP），忽略了心脏运动的作用。由于心脏是人体内最强的电活动源，其运动动态地改变躯干内主要电信号源的位置，影响电位分布，并可能改变电生理输出。在本工作中，我们提出了一种计算模型，通过将心脏机电模型与模拟躯干中电生理信号传播的模型耦合，来模拟心电图和体表电位图，这得益于一种灵活的数值方法，该方法模拟了由心肌位移引起的躯干域变形。我们的模型考虑了主要的机械-电反馈，以及从心脏到周围躯干的单向位移和电位耦合。在数值离散方面，我们采用了一种通用的网格间传递算子，允许在心脏域和躯干域使用不同的有限元空间。我们的数值结果是在一个真实的三维双心室-躯干几何模型上获得的，涵盖了窦性心律和室性心动过速（VT）两种情况，分别在动态域中求解机电-躯干模型，在静态域中求解经典电生理-躯干模型。通过比较标准12导联心电图和体表电位图，我们强调了心肌收缩对电生理输出的不可忽略的影响，尤其是在室性心动过速等病理条件下。
英文摘要：
When generating in-silico clinical electrophysiological outputs, such as electrocardiograms (ECGs) and body surface potential maps (BSPMs), mathematical models have relied on single physics, i.e. of the cardiac electrophysiology (EP), neglecting the role of the heart motion. Since the heart is the most powerful source of electrical activity in the human body, its motion dynamically shifts the position of the principal electrical sources in the torso, influencing electrical potential distribution and potentially altering the EP outputs. In this work, we propose a computational model for the simulation of ECGs and BSPMs by coupling a cardiac electromechanical model with a model that simulates the propagation of the EP signal in the torso, thanks to a flexible numerical approach, that simulates the torso domain deformation induced by the myocardial displacement. Our model accounts for the major mechano-electrical feedbacks, along with unidirectional displacement and potential couplings from the heart to the surrounding body. For the numerical discretization, we employ a versatile intergrid transfer operator that allows for the use of different Finite Element spaces to be used in the cardiac and torso domains. Our numerical results are obtained on a realistic 3D biventricular-torso geometry, and cover both cases of sinus rhythm and ventricular tachycardia (VT), solving both the electromechanical-torso model in dynamical domains, and the classical electrophysiology-torso model in static domains. By comparing standard 12-lead ECG and BSPMs, we highlight the non-negligible effects of the myocardial contraction on the EP-outputs, especially in pathological conditions, such as the VT.
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