UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Direct in-vivo assessment of global and regional mechano-electric feedback in the intact human heart

Orini, M; Taggart, P; Bhuva, A; Roberts, N; Di Salvo, C; Yates, M; Badiani, S; ... Lambiase, PD; + view all (2021) Direct in-vivo assessment of global and regional mechano-electric feedback in the intact human heart. Heart Rhythm 10.1016/j.hrthm.2021.04.026. (In press). Green open access

[img]
Preview
Text
Lambiase_Direct in-vivo assessment of global and regional mechano-electric feedback in the intact human heart_Pre-proof.pdf - Accepted version

Download (6MB) | Preview

Abstract

BACKGROUND: Inhomogeneity of ventricular contraction is associated with sudden cardiac death, but the underlying mechanisms are unclear. Alterations in cardiac contraction impact electrophysiological parameters through mechano-electric feedback. This has been shown to promote arrhythmias in experimental studies, but its effect in the in-vivo human heart is unclear. OBJECTIVE: The aim of this study was to quantify the impact of regional myocardial deformation provoked by a sudden increase in ventricular loading (aortic occlusion) on human cardiac electrophysiology. METHODS: In ten patients undergoing open-heart cardiac surgery, left ventricular (LV) afterload was modified by transient aortic occlusion. Simultaneous assessment of whole-heart electrophysiology and LV deformation was performed using an epicardial sock (240 electrodes) and speckle-tracking transoesophageal echocardiography. Parameters were matched to six AHA LV model segments. The association between changes in regional myocardial segment length and in the activation-recovery interval (ARI, a conventional surrogate for action potential duration) was studied using mixed-effect models. RESULTS: Increased ventricular loading reduced longitudinal shortening (P=0.01) and shortened the ARI (P=0.02), but changes were heterogeneous between cardiac segments. Increased regional longitudinal shortening was associated with ARI shortening (effect size 0.20, 0.01 - 0.38, ms/% P=0.04) and increased local ARI dispersion (effect size -0.13, -0.23 - -0.03) ms/%, P=0.04). At the whole organ level, increased mechanical dispersion translated into increased dispersion of repolarization (correlation coefficient, r=0.81, P=0.01). CONCLUSIONS: Mechano-electric feedback can establish a potentially pro-arrhythmic substrate in the human heart and should be considered to advance our understanding and prevention of cardiac arrhythmias.

Type: Article
Title: Direct in-vivo assessment of global and regional mechano-electric feedback in the intact human heart
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.hrthm.2021.04.026
Publisher version: https://doi.org/10.1016/j.hrthm.2021.04.026
Language: English
Additional information: This is an Open Access article published under a Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/).
Keywords: Arrhythmia, Cardiac strain, Electromechanical coupling, Mechano-electric feedback, Repolarization
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10127309
Downloads since deposit
6Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item