In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contr...In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contributions of cardiac equivalent source models and volume conductor models to the MCG are deeply and comprehensively investigated. The single dipole source model, the multiple dipoles source model and the equivalent double layer （EDL） source model are analysed and compared with the cardiac equivalent source models. Meanwhile, the effect of the volume conductor model on the MCG combined with these cardiac equivalent sources is investigated. The simulation results demonstrate that the cardiac electrophysiological information will be partly missed when only the single dipole source is taken, while the EDL source is a good option for MCG simulation and the effect of the volume conductor is smallest for the EDL source. Therefore, the EDL source is suitable for the study of MCG forward and inverse problems, and more attention should be paid to it in future MCG studies.展开更多
Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intr...Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis.展开更多
Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (G...Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (GC) could reduce myocardial ischemia-reperfusion (IR) injury in rat heart. Methods: Twelve rats were randomized to IR group and GC group, then the hearts were isolated and perfused with Langendorff apparatus. Before cardioplegia, the perfusion was stopped abruptly in IR group while slowly with 5-minute in GC group. The hearts were subjected to 30-minute ischemia and 60-minute reperfusion. The left ventricular develop pressure (LVDP) and systolic pressure (LVSP), the maximal rate of the increase and decrease of left ventricular pressure (+dp/dt<sub>max</sub>, ﹣dp/dt<sub>max</sub>) were measured by polygraph system at different time points. The recovery of the variables was expressed as the ratio of these values at individual time point after reperfusion to the baseline respectively. Results: The recovery of LVDP after reperfusion was better than that in IR group (P = 0.034). No significant difference in the recovery of LVSP, +dp/dtmax and ﹣dp/dt<sub>max</sub> between groups was observed. Conclusions: Gradual clamping could improve the recovery of LVDP after IR, suggesting that gradual clamping could reduce myocardial IR injury.展开更多
This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a ...This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a current dipole and volume currents. Then by using the simulated magnetic fields based on torso-heart model as input, the cardiac current sources--an array of current dipoles by optimal constrained linear inverse method are constructed. Next, the current dipole array reconstruction considering boundaries is compared with that in an unbounded homogeneous medium. Furthermore, the influence of random noise on reconstruction is also considered and the reconstructing effect is judged by several reconstructing parameters.展开更多
Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardi...Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardiovascular disease is atherosclerosis and,as to coronary heart disease,coronary atherosclerosis and resulting lumen stenosis,even total occlusions.In translational research,several animals,such as mice,rabbits and pigs,have been used as disease models of human atherosclerosis and related cardiovascular disorders.However,coronary lesions are either naturally rare or hard to be fast induced in these models,hence,coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions,thus unrepresentative of human coronary heart disease progression and pathology.In this review,we describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.展开更多
To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 spe...To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 specimens with severe congenital heart disease（case group） from induced abortions were enrolled in this study from March 2013 to June 2015 in our hospital. Cast models were prepared by injecting casting material into vascular lumen to demonstrate real geometries of fetal cardiovascular system. Casting effectiveness was analyzed in terms of local anatomic structures and different anatomical levels（including overall level, atrioventricular and great vascular system, left-sided and right-sided heart）, as well as different trimesters of pregnancy. In our study, all specimens were successfully casted. Casting effectiveness analysis of local anatomic structures showed a mean score from 1.90±1.45 to 3.60±0.52, without significant differences between case and control groups in most local anatomic structures except left ventricle, which had a higher score in control group（P=0.027）. Inter-group comparison of casting effectiveness in different anatomical levels showed no significant differences between the two groups. Intra-group comparison also revealed undifferentiated casting effectiveness between atrioventricular and great vascular system, or left-sided and right-sided heart in corresponding group. Third-trimester group had a significantly higher perfusion score in great vascular system than second-trimester group（P=0.046）, while the other anatomical levels displayed no such difference. Vascular corrosion technique can be successfully used in fabrication of fetal cardiovascular cast model. It is also a reliable method to demonstrate three-dimensional anatomy of severe congenital heart disease and normal heart in fetus.展开更多
The heart is one of the first functional embryonic organs occurring during development. The fundamental developmental processes and genes involved in cardiogenesis are conserved between the invertebrates and vertebrat...The heart is one of the first functional embryonic organs occurring during development. The fundamental developmental processes and genes involved in cardiogenesis are conserved between the invertebrates and vertebrates. In the past fifteen years, one of signaling pathways that has been best characterized in heart development in both invertebrates and vertebrates is the Wg/Wnt signaling pathways. Since our discovery of the Wg signaling required for the early heart development in Drosophila, the past fifteen years have witnessed tremendous progress in the understanding of specific Wnt signaling pathways in vertebrate cardiogenesis. This review will summarize the current state of knowledge of Wg signaling transduction in Drosophila heart development, which will benefit our understanding of vertebrate cardiogenesis and human congenital malformations.展开更多
The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of wea...The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.展开更多
Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on b...Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on basis of the principle of wavelet analysis considering the time-frequency characteristics of the heart murmur. This method uses Mel frequency cepstral coefficient (MFCC) to extract representative features and develops hidden Markov model (HMM) for signal classification. The result shows that this method?is able to recognize the murmur efficiently and superior to BP?neural network (94.2% vs 82.8%). And the findings suggest that the method may have the potential to be used to assist doctors for a more objective diagnosis.展开更多
Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical d...Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical discordance, increasing the risk of atrial fibrillation(AF) and myocardial ischemia. IAB was generally believed to be caused by impaired conduction along the Bachmann bundle(BB). However, there are three other conduction pathways, including the fibers posteriorly in the vicinity of the right pulmonary veins(VRPV), transseptal fibers in the fossa ovalis(FO), and muscular bundles on the inferior atrial surface near the coronary sinus(CS). We hypothesized that the importance of BB on IAB might have been overestimated. To test this hypothesis, various combinations of conduction pathway blocks were simulated based on a realistic human atrial model to investigate their effects on the index of clinical diagnosis standard of IAB using a simulated 12-lead electrocardiogram(ECG). Firstly, the results showed that the BB block alone could not generate typical P wave morphology of IAB, and that the combination of BB and VRPV pathway block played important roles in the occurrence of IAB. Secondly, although single FO and CS pathways play subordinate roles in inter atrial conduction, their combination with BB and VRPV block could also produce severe IAB. In summary, this simulation study has demonstrated that the combinations of different inter atrial conduction pathways, rather than BB alone, resulted in ECG morphology of IAB. Attention needs to be paid to this in future pathophysiological and clinical studies of IAB.展开更多
背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风...背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风险预测模型,为相关风险预测模型的构建、选择与推广提供参考。方法检索中国知网、维普网、万方数据库知识服务平台、中国生物医学文献服务系统、PubMed、Cochrane Library、Web of Science、Embase数据库与我国冠心病患者并发心力衰竭风险预测模型相关的研究,检索时限为建库至2024年10月。由2名研究者独立筛选文献并提取信息,使用预测模型偏倚风险评价工具(PROBAST)评估纳入研究的偏倚风险及适用性。结果共纳入27篇文献,报告了64个风险预测模型的开发情况,模型的受试者工作特征(ROC)曲线下面积(AUC)为0.511~0.989,其中63个模型AUC>0.7,提示模型整体预测性能较好;偏倚风险评估工具评估结果显示,纳入的27篇文献均为高偏倚风险,适用性偏低。年龄、左心室射血分数、糖尿病病史、高血压病史、N末端B型钠尿肽前体、Gensini评分是模型中纳入的重要预测因子。结论当前我国冠心病患者并发心力衰竭风险预测模型的稳定性和外推性有待行前瞻性、大样本研究验证,后续建模应当严格遵循PROBAST指南设计实施研究,以开发可推广性强的高质量预测模型。展开更多
It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current mult...It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current multipole model expanded to the first order terms. This magnetic imaging is realized in a reconstruction plane in the centre of human heart, where the current dipole array is employed to represent realistic cardiac current distribution. The current multipole as testing source generates magnetic fields in the measuring plane, serving as inputs of cardiac magnetic inverse problem. In the heart-torso model constructed by boundary element method, the current multipole magnetic field distribution is compared with that in the homogeneous infinite space, and also with the single current dipole magnetic field distribution. Then the minimum-norm least-squares （MNLS） method, the optimal weighted pseudoinverse method （OWPIM）, and the optimal constrained linear inverse method （OCLIM） are selected as the algorithms for inverse computation based on current multipole model innovatively, and the imaging effects of these three inverse methods are compared. Besides, two reconstructing parameters, residual and mean residual, are also discussed, and their trends under MNLS, OWPIM and OCLIM each as a function of SNR are obtained and compared.展开更多
Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR)...Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR),has yielded mixed results with some patients recover RV function and some do not.An innovative surgical approach was proposed to help ventricle to contract and improve RV function qualified by ejection fraction with one or more active contracting bands.Computational biomechanical modelling is a widely used method in cardiovascular study for investigation of mechanisms governing disease development,quantitative diagnostic and treatment strategies and improving surgical designs for better outcome.Muscle active contraction caused by zero-load sarcomere shortening leads to change of zero-load configurations.In lieu of experimenting using real surgery on animal or human,computational simulations(virtual surgery)were performed to test different band combination and insertion options to identify optimal surgery design and band insertion plan.Methods Cardiac magnetic resonance(CMR)data were obtained from one rTOF patient(sex:male,age:22.5 y)before pulmonary valve replacement surgery.The patient was suffering from RV dilation and dysfunction with RV end-systole volume 254.49ml and end-diastole volume 406.91 mL.A total of 15 computational RV/LV/Patch/Band combination models based on(CMR)imaging were constructed to investigate the influence of different band insertion surgery plans.These models included 5 different band insertion models combined and 3 different band contraction ratio(10%,15%and 20%band zero-stress length reduction).These models included 5 different band insertion models:Model 1 with one band at anterior to the middle of papillary muscle;Model 2 with one band at posterior to the middle of papillary muscle;Model 3 with 2 bands which are the ones from Models 1&2 combined;Model 4 with a band at the base of the papillary muscle;Model 5 with 3 bands which is a combination of Models 3&4.A pre-shrink process was performed on in-vivo begin-filling and end-systole MRI data to obtain diastole and systole zero4oad ventricle geometries.An extra 5%-8%shrinkage was applied to obtain corresponding systole zero-load geometry reflecting myocardium sarcomere shortening.The zero-load band length in systole was 10%,15%and 20%shorter than that in diastole according to their corresponding contraction ratio.The nonlinear Mooney-Rivlin model was used to describe the ventricle material properties with their material parameter values adjusted to match measured data with CMR.The band material properties were in the same scale with healthy right ventricle.The RV/LV/Band model construction and solution procedures were the same as described.Results Model 5 with band contraction ratio of 20%has the ability to improve RV ejection fraction to 41.07%,which represented a 3.61%absolute improvement,or 9.6%relative improvement using pre-PVR ejection fraction as the baseline number.The ejection fractions for Models 1-4 with band contraction ratio of 20%were 39.28%,39.47%,38.87%and 40.34%respectively.Compared to models with band contraction ratio15%and 20%,models with band contraction ratio 10%has the least ability on RV ejection fraction improvement with ejection fraction 38.28%,38.00%,38.81%,38.50%and 39.36%corresponding to Models 1-5.Conclusions This pilot work demonstrated that the band insertion surgery may have great potential to improve post-PVR RV cardiac function for patients with repaired TOF.More band contraction ratio and inserted band number may lead to better post-surgery outcome.Further investigations using in-vitro animal experiments and final patient studies are warranted.展开更多
Various steady models for interaction between heart and arterial system have been given in liter- ature,In our recent study,a dynamic principle,i.e.the principle of least cardiac work is proposed,and a dy- namic model...Various steady models for interaction between heart and arterial system have been given in liter- ature,In our recent study,a dynamic principle,i.e.the principle of least cardiac work is proposed,and a dy- namic model for interaction of heart and arterial system is established.Preliminary results of our experiments show that both the principle and the model are consistent with the physiological phenomena.It reveals that the pres- ent analysis may offer a new measure for the study of dynamic process of interaction between heart and arterial system.展开更多
Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs mo...Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.展开更多
Remodeling of ion channels is an important mechanism of arrhythmia induced by heart failure （HF）. We investigated the expression of potassium channel encoding genes in the ventricles of rabbit established by volumeo...Remodeling of ion channels is an important mechanism of arrhythmia induced by heart failure （HF）. We investigated the expression of potassium channel encoding genes in the ventricles of rabbit established by volumeoverload operation followed with pressure-overload. The reversible effect of these changes with bisoprolol was also evaluated. The HF group exhibited left ventricular enlargement, systolic dysfunction, prolongation of corrected QT interval （QTc）, and increased plasma brain natriuretic peptide levels in the HF rabbits. Several potassium channel subunit encoding genes were consistently down-regulated in the HF rabbits. After bisoprolol treatment, heart function was improved significantly and QTc was shortened. Additionally, the mRNA expression of potassium channel subunit genes could be partially reversed. The down-regulated expression of potassium channel subunits Kv4.3, Kv1.4, KvLQT1, minK and Kir 2.1 may contribute to the prolongation of action potential duration in the heart of rabbits induced by volume combined with pressure overload HF. Bisoprolol could partially reverse these down-regulations and improve heart function.展开更多
Objective： To observe the effects of atorvastatin on serum matrix metalloproteinase-2（MMP-2）, matrix metaUoproteinase-9（MMP-9）, and the tissue inhibitor of metalloproteinase-1（TIMP-1） in the development of chro...Objective： To observe the effects of atorvastatin on serum matrix metalloproteinase-2（MMP-2）, matrix metaUoproteinase-9（MMP-9）, and the tissue inhibitor of metalloproteinase-1（TIMP-1） in the development of chronic heart failure. To investigate the role of atorvastatin in the therapy of chronic heart failure and determine its possible mechanism of action. Methods： Thirty Japanese Big Ear rabbits were randomly selected and divided into 3 groups： sham-operated group（SO group）, heart failure control group（HC group） and heart failure atorvastatin therapy group（HA group）, with 6, 12 and 12 animals in the respective groups. Volume overloading was produced in the HC group and HA group animals by creating an aortic insufficiency, induced by damaging the aortic valve with a catheter introduced through the carotid artery. After 14 days, abdominal aorta constriction was performed in order to obtain a pressure overload. Six weeks later rabbits in the HA group were administered atorvastatin 3mg· Kg^-1·d^-1 for 4 weeks, at which time the experiment was terminated. Arterial blood was drawn and serum levels of MMP-2, MMP-9 and TIMP-1 were measured in all groups at the same time using an ELISA method. Results： Structural and functional indicators of chronic heart failure（CHF） were seen in both the HC and HA groups, but atorvastatin significantly reduced the observed effects. The serum concentrations of MMP-2, MMP-9 and TIMP-1 were at low levels in all three groups at the start of the study, with no difference between them（P 〈 0.05）. At the end of 6th week concentrations were significantly increased in the HC and HA groups compared with the SO group（P 〈 0.05）, but there were no differences between the HC group and HA group（P 〉 0.05）. The increased concentrations in HC group continued to the end of the experiment, but values in the HA group were all lower than those in the HC group by the end of the experiment（P 〈 0.05）. Conclusion： Serum concentrations of MMP-2, MMP-9 and TIMP-1 increase significantly during the course of CHF, paralleling the pathological progress of CHF. Atorvastatin benefits CHF, and the decreased serum levels of MMP-2, MMP-9 and TIMP-1 may be one of the drug＇ s mechanism of action.展开更多
基金supported by the State Key Development Program for Basic Research of China (Grant Nos. 2007CB512100 and2006CB601007)the National Natural Science Foundation of China (Grant No. 10674006)+2 种基金the National High Technology Research and Development Program of China (Grant No. 2007AA03Z238)China Postdoctoral Science Foundation (Grant No. 20090461376)the Fundamental Research Funds for the Central Universities (Grant No. KYJD09001)
文摘In this paper, we present a magnetocardiogram （MCG） simulation study using the boundary element method （BEM） and based on the virtual heart model and the realistic human volume conductor model. The different contributions of cardiac equivalent source models and volume conductor models to the MCG are deeply and comprehensively investigated. The single dipole source model, the multiple dipoles source model and the equivalent double layer （EDL） source model are analysed and compared with the cardiac equivalent source models. Meanwhile, the effect of the volume conductor model on the MCG combined with these cardiac equivalent sources is investigated. The simulation results demonstrate that the cardiac electrophysiological information will be partly missed when only the single dipole source is taken, while the EDL source is a good option for MCG simulation and the effect of the volume conductor is smallest for the EDL source. Therefore, the EDL source is suitable for the study of MCG forward and inverse problems, and more attention should be paid to it in future MCG studies.
基金Project supported by the National Natural Science Foundation of China(Nos.61527811 and 61701435)
文摘Left anterior fascicular block（LAFB） is a heart disease identifiable from an abnormal electrocardiogram（ECG）. It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis.
文摘Objectives: We hypothesized that the organisms and their organs or tissues could adapt themselves to the gradual changes of environment for surviving or reducing damage. This study explored whether gradual clamping (GC) could reduce myocardial ischemia-reperfusion (IR) injury in rat heart. Methods: Twelve rats were randomized to IR group and GC group, then the hearts were isolated and perfused with Langendorff apparatus. Before cardioplegia, the perfusion was stopped abruptly in IR group while slowly with 5-minute in GC group. The hearts were subjected to 30-minute ischemia and 60-minute reperfusion. The left ventricular develop pressure (LVDP) and systolic pressure (LVSP), the maximal rate of the increase and decrease of left ventricular pressure (+dp/dt<sub>max</sub>, ﹣dp/dt<sub>max</sub>) were measured by polygraph system at different time points. The recovery of the variables was expressed as the ratio of these values at individual time point after reperfusion to the baseline respectively. Results: The recovery of LVDP after reperfusion was better than that in IR group (P = 0.034). No significant difference in the recovery of LVSP, +dp/dtmax and ﹣dp/dt<sub>max</sub> between groups was observed. Conclusions: Gradual clamping could improve the recovery of LVDP after IR, suggesting that gradual clamping could reduce myocardial IR injury.
基金Project supported by the State Key Development Program for Basic Research of China(Grant No.2006CB601007)the National Natural Science Foundation of China(Grant No.10674006)the National High Technology Research and Development Program of China(Grant No.2007AA03Z238)
文摘This paper constructs a concentric ellipsoid torso-heart model by boundary element method and investigates the impacts of model structures on the cardiac magnetic fields generated by both equivalent primary source--a current dipole and volume currents. Then by using the simulated magnetic fields based on torso-heart model as input, the cardiac current sources--an array of current dipoles by optimal constrained linear inverse method are constructed. Next, the current dipole array reconstruction considering boundaries is compared with that in an unbounded homogeneous medium. Furthermore, the influence of random noise on reconstruction is also considered and the reconstructing effect is judged by several reconstructing parameters.
文摘Cardiovascular disease,predominantly coronary heart disease and stroke,leads to high morbidity and mortality not only in developed worlds but also in underdeveloped regions.The dominant pathologic foundation for cardiovascular disease is atherosclerosis and,as to coronary heart disease,coronary atherosclerosis and resulting lumen stenosis,even total occlusions.In translational research,several animals,such as mice,rabbits and pigs,have been used as disease models of human atherosclerosis and related cardiovascular disorders.However,coronary lesions are either naturally rare or hard to be fast induced in these models,hence,coronary heart disease induction mostly relies on surgical or pharmaceutical interventions with no or limited primary coronary lesions,thus unrepresentative of human coronary heart disease progression and pathology.In this review,we describe the progress of animal models of coronary heart disease following either spontaneous or diet-accelerated coronary lesions.
基金supported by grants from the National Natural Science Foundation of China(No.81530056 and No.81501494)Hubei Province Health and Family Planning Scientific Research Project(No.WJ2015MB016)Hubei Provincial Key Laboratory of Molecular Imaging Foundation,China(No.02.03.2014-29)
文摘To investigate the application and effectiveness of vascular corrosion technique in preparing fetal cardiovascular cast models, 10 normal fetal heart specimens with other congenital disease（control group） and 18 specimens with severe congenital heart disease（case group） from induced abortions were enrolled in this study from March 2013 to June 2015 in our hospital. Cast models were prepared by injecting casting material into vascular lumen to demonstrate real geometries of fetal cardiovascular system. Casting effectiveness was analyzed in terms of local anatomic structures and different anatomical levels（including overall level, atrioventricular and great vascular system, left-sided and right-sided heart）, as well as different trimesters of pregnancy. In our study, all specimens were successfully casted. Casting effectiveness analysis of local anatomic structures showed a mean score from 1.90±1.45 to 3.60±0.52, without significant differences between case and control groups in most local anatomic structures except left ventricle, which had a higher score in control group（P=0.027）. Inter-group comparison of casting effectiveness in different anatomical levels showed no significant differences between the two groups. Intra-group comparison also revealed undifferentiated casting effectiveness between atrioventricular and great vascular system, or left-sided and right-sided heart in corresponding group. Third-trimester group had a significantly higher perfusion score in great vascular system than second-trimester group（P=0.046）, while the other anatomical levels displayed no such difference. Vascular corrosion technique can be successfully used in fabrication of fetal cardiovascular cast model. It is also a reliable method to demonstrate three-dimensional anatomy of severe congenital heart disease and normal heart in fetus.
基金supported in part by the National Basic Research Program of China (No.2005CB522505)the National Natural Science Foundation of China (No.30930054)
文摘The heart is one of the first functional embryonic organs occurring during development. The fundamental developmental processes and genes involved in cardiogenesis are conserved between the invertebrates and vertebrates. In the past fifteen years, one of signaling pathways that has been best characterized in heart development in both invertebrates and vertebrates is the Wg/Wnt signaling pathways. Since our discovery of the Wg signaling required for the early heart development in Drosophila, the past fifteen years have witnessed tremendous progress in the understanding of specific Wnt signaling pathways in vertebrate cardiogenesis. This review will summarize the current state of knowledge of Wg signaling transduction in Drosophila heart development, which will benefit our understanding of vertebrate cardiogenesis and human congenital malformations.
文摘The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.
文摘Heart murmur recognition and classification play an important role in the auscultative diagnosis. The method based on hidden markov model (HMM) was presented to recognize the heart murmur. The murmur was isolated on basis of the principle of wavelet analysis considering the time-frequency characteristics of the heart murmur. This method uses Mel frequency cepstral coefficient (MFCC) to extract representative features and develops hidden Markov model (HMM) for signal classification. The result shows that this method?is able to recognize the murmur efficiently and superior to BP?neural network (94.2% vs 82.8%). And the findings suggest that the method may have the potential to be used to assist doctors for a more objective diagnosis.
基金Project supported by the National R&D Program for Major Research Instruments of China(No.61527811)the National Natural Science Foundation of China(No.61701435)the Zhejiang Provincial Natural Science Foundation of China(No.LY17H180003)
文摘Inter atrial block(IAB) is a prevailing cardiac conduction abnormality that is under-recognized in clinical practice. IAB has strong association with atrial arrhythmia, left atrial enlargement, and electromechanical discordance, increasing the risk of atrial fibrillation(AF) and myocardial ischemia. IAB was generally believed to be caused by impaired conduction along the Bachmann bundle(BB). However, there are three other conduction pathways, including the fibers posteriorly in the vicinity of the right pulmonary veins(VRPV), transseptal fibers in the fossa ovalis(FO), and muscular bundles on the inferior atrial surface near the coronary sinus(CS). We hypothesized that the importance of BB on IAB might have been overestimated. To test this hypothesis, various combinations of conduction pathway blocks were simulated based on a realistic human atrial model to investigate their effects on the index of clinical diagnosis standard of IAB using a simulated 12-lead electrocardiogram(ECG). Firstly, the results showed that the BB block alone could not generate typical P wave morphology of IAB, and that the combination of BB and VRPV pathway block played important roles in the occurrence of IAB. Secondly, although single FO and CS pathways play subordinate roles in inter atrial conduction, their combination with BB and VRPV block could also produce severe IAB. In summary, this simulation study has demonstrated that the combinations of different inter atrial conduction pathways, rather than BB alone, resulted in ECG morphology of IAB. Attention needs to be paid to this in future pathophysiological and clinical studies of IAB.
文摘背景心力衰竭是严重危害人类健康的重大慢性疾病,冠心病是心力衰竭最常见的病因,针对冠心病并发心力衰竭的危险因素构建风险预测模型,有助于医务人员对心力衰竭高危人群进行早期识别和干预。目的系统评价我国冠心病患者并发心力衰竭风险预测模型,为相关风险预测模型的构建、选择与推广提供参考。方法检索中国知网、维普网、万方数据库知识服务平台、中国生物医学文献服务系统、PubMed、Cochrane Library、Web of Science、Embase数据库与我国冠心病患者并发心力衰竭风险预测模型相关的研究,检索时限为建库至2024年10月。由2名研究者独立筛选文献并提取信息,使用预测模型偏倚风险评价工具(PROBAST)评估纳入研究的偏倚风险及适用性。结果共纳入27篇文献,报告了64个风险预测模型的开发情况,模型的受试者工作特征(ROC)曲线下面积(AUC)为0.511~0.989,其中63个模型AUC>0.7,提示模型整体预测性能较好;偏倚风险评估工具评估结果显示,纳入的27篇文献均为高偏倚风险,适用性偏低。年龄、左心室射血分数、糖尿病病史、高血压病史、N末端B型钠尿肽前体、Gensini评分是模型中纳入的重要预测因子。结论当前我国冠心病患者并发心力衰竭风险预测模型的稳定性和外推性有待行前瞻性、大样本研究验证,后续建模应当严格遵循PROBAST指南设计实施研究,以开发可推广性强的高质量预测模型。
基金Project supported by the State Key Development Program for Basic Research of China(Grant No.2006CB601007)the National Natural Science Foundation of China(Grant No.10674006)the National High Technology Research and Development Program of China(Grant No.2007AA03Z238)
文摘It is widely accepted that the heart current source can be reduced into a current multipole. By adopting three linear inverse methods, the cardiac magnetic imaging is achieved in this article based on the current multipole model expanded to the first order terms. This magnetic imaging is realized in a reconstruction plane in the centre of human heart, where the current dipole array is employed to represent realistic cardiac current distribution. The current multipole as testing source generates magnetic fields in the measuring plane, serving as inputs of cardiac magnetic inverse problem. In the heart-torso model constructed by boundary element method, the current multipole magnetic field distribution is compared with that in the homogeneous infinite space, and also with the single current dipole magnetic field distribution. Then the minimum-norm least-squares （MNLS） method, the optimal weighted pseudoinverse method （OWPIM）, and the optimal constrained linear inverse method （OCLIM） are selected as the algorithms for inverse computation based on current multipole model innovatively, and the imaging effects of these three inverse methods are compared. Besides, two reconstructing parameters, residual and mean residual, are also discussed, and their trends under MNLS, OWPIM and OCLIM each as a function of SNR are obtained and compared.
基金supported in part by National Sciences Foundation of China grants ( 11672001, 81571691,81771844)
文摘Objective Patients with repaired tetralogy of Fallot(rTOF)account for the majority of cases with late onset right ventricle(RV)failure.The current surgical approach,including pulmonary valve replacement/insertion(PVR),has yielded mixed results with some patients recover RV function and some do not.An innovative surgical approach was proposed to help ventricle to contract and improve RV function qualified by ejection fraction with one or more active contracting bands.Computational biomechanical modelling is a widely used method in cardiovascular study for investigation of mechanisms governing disease development,quantitative diagnostic and treatment strategies and improving surgical designs for better outcome.Muscle active contraction caused by zero-load sarcomere shortening leads to change of zero-load configurations.In lieu of experimenting using real surgery on animal or human,computational simulations(virtual surgery)were performed to test different band combination and insertion options to identify optimal surgery design and band insertion plan.Methods Cardiac magnetic resonance(CMR)data were obtained from one rTOF patient(sex:male,age:22.5 y)before pulmonary valve replacement surgery.The patient was suffering from RV dilation and dysfunction with RV end-systole volume 254.49ml and end-diastole volume 406.91 mL.A total of 15 computational RV/LV/Patch/Band combination models based on(CMR)imaging were constructed to investigate the influence of different band insertion surgery plans.These models included 5 different band insertion models combined and 3 different band contraction ratio(10%,15%and 20%band zero-stress length reduction).These models included 5 different band insertion models:Model 1 with one band at anterior to the middle of papillary muscle;Model 2 with one band at posterior to the middle of papillary muscle;Model 3 with 2 bands which are the ones from Models 1&2 combined;Model 4 with a band at the base of the papillary muscle;Model 5 with 3 bands which is a combination of Models 3&4.A pre-shrink process was performed on in-vivo begin-filling and end-systole MRI data to obtain diastole and systole zero4oad ventricle geometries.An extra 5%-8%shrinkage was applied to obtain corresponding systole zero-load geometry reflecting myocardium sarcomere shortening.The zero-load band length in systole was 10%,15%and 20%shorter than that in diastole according to their corresponding contraction ratio.The nonlinear Mooney-Rivlin model was used to describe the ventricle material properties with their material parameter values adjusted to match measured data with CMR.The band material properties were in the same scale with healthy right ventricle.The RV/LV/Band model construction and solution procedures were the same as described.Results Model 5 with band contraction ratio of 20%has the ability to improve RV ejection fraction to 41.07%,which represented a 3.61%absolute improvement,or 9.6%relative improvement using pre-PVR ejection fraction as the baseline number.The ejection fractions for Models 1-4 with band contraction ratio of 20%were 39.28%,39.47%,38.87%and 40.34%respectively.Compared to models with band contraction ratio15%and 20%,models with band contraction ratio 10%has the least ability on RV ejection fraction improvement with ejection fraction 38.28%,38.00%,38.81%,38.50%and 39.36%corresponding to Models 1-5.Conclusions This pilot work demonstrated that the band insertion surgery may have great potential to improve post-PVR RV cardiac function for patients with repaired TOF.More band contraction ratio and inserted band number may lead to better post-surgery outcome.Further investigations using in-vitro animal experiments and final patient studies are warranted.
文摘Various steady models for interaction between heart and arterial system have been given in liter- ature,In our recent study,a dynamic principle,i.e.the principle of least cardiac work is proposed,and a dy- namic model for interaction of heart and arterial system is established.Preliminary results of our experiments show that both the principle and the model are consistent with the physiological phenomena.It reveals that the pres- ent analysis may offer a new measure for the study of dynamic process of interaction between heart and arterial system.
基金supported by Zhangjiakou Project of Science and Technology Studies and Development Planning(Grand No.1321078D)
文摘Objective: To investigate the electrophysiological changes of autonomic cells in left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with chronic heart failure.Methods: Guinea pigs model of iron deficiency anemia complicated with chronic heart failure in 10 guinea pigs of the experimental group was made by feeding a low iron diet,pure water and subcutaneous injection of isoproterenol. The control group consisting of 11 guinea pigs was given normal food, normal water and injected with normal saline. The left ventricular outflow tract model specimen was also prepared. The standard microelectrode technique was used to observe electrophysiological changes of autonomic cells in the outflow tract of left ventricular heart failure complicated with iron deficiency anemia in guinea pig model. The indicators of observation were maximal diastolic potential, action potential amplitude, 0 phase maximal depolarization velocity, 4 phase automatic depolarization velocity, repolarization 50% and 90%, and spontaneous discharge frequency.Results: Compared with the control group, 4 phase automatic depolarization velocity,spontaneous discharge frequency and 0 phase maximal depolarization velocity decreased significantly(P < 0.01) and action potential amplitude reduced(P < 0.01) in model group. Moreover, repolarization 50% and 90% increased(P < 0.01).Conclusions: There are electrophysiological abnormalities of the left ventricular outflow tract in guinea pigs with iron deficiency anemia complicated with heart failure.
基金supported by the State Key Program of the National Natural Science Foundation of China (No. 30830051)
文摘Remodeling of ion channels is an important mechanism of arrhythmia induced by heart failure （HF）. We investigated the expression of potassium channel encoding genes in the ventricles of rabbit established by volumeoverload operation followed with pressure-overload. The reversible effect of these changes with bisoprolol was also evaluated. The HF group exhibited left ventricular enlargement, systolic dysfunction, prolongation of corrected QT interval （QTc）, and increased plasma brain natriuretic peptide levels in the HF rabbits. Several potassium channel subunit encoding genes were consistently down-regulated in the HF rabbits. After bisoprolol treatment, heart function was improved significantly and QTc was shortened. Additionally, the mRNA expression of potassium channel subunit genes could be partially reversed. The down-regulated expression of potassium channel subunits Kv4.3, Kv1.4, KvLQT1, minK and Kir 2.1 may contribute to the prolongation of action potential duration in the heart of rabbits induced by volume combined with pressure overload HF. Bisoprolol could partially reverse these down-regulations and improve heart function.
文摘Objective： To observe the effects of atorvastatin on serum matrix metalloproteinase-2（MMP-2）, matrix metaUoproteinase-9（MMP-9）, and the tissue inhibitor of metalloproteinase-1（TIMP-1） in the development of chronic heart failure. To investigate the role of atorvastatin in the therapy of chronic heart failure and determine its possible mechanism of action. Methods： Thirty Japanese Big Ear rabbits were randomly selected and divided into 3 groups： sham-operated group（SO group）, heart failure control group（HC group） and heart failure atorvastatin therapy group（HA group）, with 6, 12 and 12 animals in the respective groups. Volume overloading was produced in the HC group and HA group animals by creating an aortic insufficiency, induced by damaging the aortic valve with a catheter introduced through the carotid artery. After 14 days, abdominal aorta constriction was performed in order to obtain a pressure overload. Six weeks later rabbits in the HA group were administered atorvastatin 3mg· Kg^-1·d^-1 for 4 weeks, at which time the experiment was terminated. Arterial blood was drawn and serum levels of MMP-2, MMP-9 and TIMP-1 were measured in all groups at the same time using an ELISA method. Results： Structural and functional indicators of chronic heart failure（CHF） were seen in both the HC and HA groups, but atorvastatin significantly reduced the observed effects. The serum concentrations of MMP-2, MMP-9 and TIMP-1 were at low levels in all three groups at the start of the study, with no difference between them（P 〈 0.05）. At the end of 6th week concentrations were significantly increased in the HC and HA groups compared with the SO group（P 〈 0.05）, but there were no differences between the HC group and HA group（P 〉 0.05）. The increased concentrations in HC group continued to the end of the experiment, but values in the HA group were all lower than those in the HC group by the end of the experiment（P 〈 0.05）. Conclusion： Serum concentrations of MMP-2, MMP-9 and TIMP-1 increase significantly during the course of CHF, paralleling the pathological progress of CHF. Atorvastatin benefits CHF, and the decreased serum levels of MMP-2, MMP-9 and TIMP-1 may be one of the drug＇ s mechanism of action.
