The interplay between structural and electrical changes in the heart after myocardial infarction (MI) plays a key role in the initiation and maintenance of arrhythmia. The anatomical and electrophysiological properties of scar, border zone, and normal myocardium modify the electrocardiographic morphology, which is routinely analysed in clinical settings. However, the influence of various MI properties on the QRS is not intuitively predictable.In this work, we have systematically investigated the effects of 17 post-MI scenarios, varying the location, size, transmural extent, and conductive level of scarring and border zone area, on the forward-calculated QRS. Additionally, we have compared the contributions of different QRS score criteria for quantifying post-MI pathophysiology.The propagation of electrical activity in the ventricles is simulated via a Eikonal model on a unified coordinate system.The analysis has been performed on 49 subjects, and the results imply that the QRS is capable of identifying MI, suggesting the feasibility of inversely reconstructing infarct regions from QRS.There exist sensitivity variations of different QRS criteria for identifying 17 MI scenarios, which is informative for solving the inverse problem.
翻译:冠心病心肌梗死(MI)后心脏结构和电学变化之间的相互作用在心律失常的发生和维持中起着关键作用。瘢痕、边缘区和正常心肌的解剖和电生理特性修改了心电图形态,在临床设置中通常进行分析。然而,各种MI特性对QRS的影响并不直观可预测。在这项工作中,我们系统地研究了17种MI情况对前向计算的QRS的影响,包括瘢痕和边缘区面积的位置、大小、经膜范围和传导电平变化。此外,我们比较了不同QRS评分标准对量化MI病理生理的贡献。利用统一的坐标系通过Eikonal模型模拟了心室内电活动的传播。分析在49名受试者中进行,结果暗示QRS能够识别MI,这表明可以从QRS中逆向重构梗死区域。不同QRS标准识别17种MI情况的灵敏度存在差异,这对解决逆问题具有信息价值。