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Differences in ventricular wall composition may explain inter-patient variability in the ECG response to variations in serum potassium and calcium
hal.structure.identifier | Aragón Institute of Engineering Research [Zaragoza] [I3A] | |
hal.structure.identifier | Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine [CIBER-BBN] | |
hal.structure.identifier | Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN] | |
hal.structure.identifier | Institut de Mathématiques de Bordeaux [IMB] | |
dc.contributor.author | BUKHARI, Hassaan | |
hal.structure.identifier | Aragón Institute of Engineering Research [Zaragoza] [I3A] | |
hal.structure.identifier | Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine [CIBER-BBN] | |
dc.contributor.author | SÁNCHEZ, Carlos | |
hal.structure.identifier | Aragón Institute of Engineering Research [Zaragoza] [I3A] | |
hal.structure.identifier | Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine [CIBER-BBN] | |
dc.contributor.author | LAGUNA, Pablo | |
hal.structure.identifier | IHU-LIRYC | |
hal.structure.identifier | Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN] | |
hal.structure.identifier | Institut de Mathématiques de Bordeaux [IMB] | |
dc.contributor.author | POTSE, Mark | |
hal.structure.identifier | Aragón Institute of Engineering Research [Zaragoza] [I3A] | |
hal.structure.identifier | Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine [CIBER-BBN] | |
dc.contributor.author | PUEYO, Esther | |
dc.date.accessioned | 2024-04-04T02:30:59Z | |
dc.date.available | 2024-04-04T02:30:59Z | |
dc.date.created | 2023-10-11 | |
dc.date.issued | 2023-10-11 | |
dc.identifier.issn | 1664-042X | |
dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/190279 | |
dc.description.abstractEn | Objective: Chronic kidney disease patients have a decreased ability to maintain normal electrolyte concentrations in their blood, which increases the risk for ventricular arrhythmias and sudden cardiac death. Non-invasive monitoring of serum potassium and calcium concentration, [K + ] and [Ca 2+ ], can help to prevent arrhythmias in these patients. Electrocardiogram (ECG) markers that significantly correlate with [K + ] and [Ca 2+ ] have been proposed, but these relations are highly variable between patients. We hypothesized that inter-individual differences in cell type distribution across the ventricular wall can help to explain this variability. Methods: A population of human heart-torso models were built with different proportions of endocardial, midmyocardial and epicardial cells. Propagation of ventricular electrical activity was described by a reaction-diffusion model, with modified Ten Tusscher-Panfilov dynamics. [K + ] and [Ca 2+ ] were varied individually and in combination. Twelve-lead ECGs were simulated and the width, amplitude and morphological variability of T waves and QRS complexes were quantified. Results were compared to measurements from 29 end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Results: Both simulations and patients data showed that most of the analyzed T wave and QRS complex markers correlated strongly with [K + ] (absolute median Pearson correlation coefficients, r , ranging from 0.68 to 0.98) and [Ca 2+ ] (ranging from 0.70 to 0.98). The same sign and similar magnitude of median r was observed in the simulations and the patients. Different cell type distributions in the ventricular wall led to variability in ECG markers that was accentuated at high [K + ] and low [Ca 2+ ], in agreement with the larger variability between patients measured at the onset of HD. The simulated ECG variability explained part of the measured inter-patient variability. Conclusion: Changes in ECG markers were similarly related to [K + ] and [Ca 2+ ] variations in our models and in the ESRD patients. The high inter-patient ECG variability may be explained by variations in cell type distribution across the ventricular wall, with high sensitivity to variations in the proportion of epicardial cells. Significance: Differences in ventricular wall composition help to explain inter-patient variability in ECG response to [K + ] and [Ca 2+ ]. This finding can be used to improve serum electrolyte monitoring in ESRD patients. | |
dc.description.sponsorship | L'Institut de Rythmologie et modélisation Cardiaque - ANR-10-IAHU-0004 | |
dc.language.iso | en | |
dc.publisher | Frontiers | |
dc.rights.uri | http://creativecommons.org/licenses/by/ | |
dc.subject.en | ECG | |
dc.subject.en | T wave morphology | |
dc.subject.en | QRS complex morphology | |
dc.subject.en | transmural heterogeneity | |
dc.subject.en | potassium | |
dc.subject.en | calcium | |
dc.subject.en | hemodialysis | |
dc.subject.en | heart-torso models | |
dc.title.en | Differences in ventricular wall composition may explain inter-patient variability in the ECG response to variations in serum potassium and calcium | |
dc.type | Article de revue | |
dc.identifier.doi | 10.3389/fphys.2023.1060919 | |
dc.subject.hal | Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Cardiologie et système cardiovasculaire | |
dc.description.sponsorshipEurope | Personalised In-Silico Cardiology | |
bordeaux.journal | Frontiers in Physiology | |
bordeaux.page | 1060919 | |
bordeaux.volume | 14 | |
bordeaux.hal.laboratories | Institut de Mathématiques de Bordeaux (IMB) - UMR 5251 | * |
bordeaux.institution | Université de Bordeaux | |
bordeaux.institution | Bordeaux INP | |
bordeaux.institution | CNRS | |
bordeaux.peerReviewed | oui | |
hal.identifier | hal-04407773 | |
hal.version | 1 | |
hal.popular | non | |
hal.audience | Internationale | |
hal.origin.link | https://hal.archives-ouvertes.fr//hal-04407773v1 | |
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