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Differences between models of partial thickness and subendocardial ischaemia in terms of sensitivity analyses of ST-segment epicardial potential distributions.

Authors
  • Johnston, Barbara M1
  • Johnston, Peter R2
  • 1 School of Environment and Science, and Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia. Electronic address: [email protected] , (Australia)
  • 2 School of Environment and Science, and Queensland Micro- and Nanotechnology Centre, Griffith University, Nathan, Queensland 4111, Australia. , (Australia)
Type
Published Article
Journal
Mathematical biosciences
Publication Date
Oct 21, 2019
Volume
318
Pages
108273–108273
Identifiers
DOI: 10.1016/j.mbs.2019.108273
PMID: 31647934
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Mathematical modelling is a useful technique to help elucidate the connection between non-transmural ischaemia and ST elevation and depression of the ECG. Generally, models represent non-transmural ischaemia using an ischaemic zone that extends from the endocardium partway to the epicardium. However, recent experimental work has suggested that ischaemia typically arises within the heart wall. This work examines the effect of modelling cardiac ischaemia in the left ventricle using two different models: subendocardial ischaemia and partial thickness ischaemia, representing the first and second scenarios, respectively. We found that it is possible, only in the model of subendocardial ischaemia, to see a single minimum on the epicardial surface above the ischaemic region, and this only occurs for low ischaemic thicknesses. This may help to explain the rarity of ST depression that is located over the ischaemic region. It was also found that, in both models, the epicardial potential distribution is most sensitive to the proximity of the ischaemic region to the epicardium, rather than to the thickness of the ischaemic region. Since proximity does not indicate the thickness of the ischaemic region, this suggests a reason why it may be difficult to determine the degree of ischaemia using the ST segment of the ECG. Copyright © 2019 Elsevier Inc. All rights reserved.

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