Ibrahim Marai1,2, David Carasso3, Shaqed Carasso4, Shemy Carasso1,2. 1. Cardiovascular division, B PadehPoriyaMedical Center, Poriya, Israel. 2. The Azrieli Faculty of Medicine, Bar Ilan University, Zefat, Israel. 3. Faculty of Electrical Engineering, the Technion, Israel Institute of Technology, Haifa, Israel. 4. Department of Cell Biology and Cancer Science, The Rappaport Faculty of Medicine, Technion, Israel Institute of Technology,Technion Integrated Cancer Center, Haifa, Israel.
Abstract
PURPOSE: To simulate the effect of decreasing conduction velocity (Cvel) on average segmental myocardial strain using mathematical modeling. METHODS: The simulation was run using MatLab version 7.4 (The MathWorks, Inc. Natick, Massachusetts). A normal strain-time curve pattern was sampled from a normal human echo study using the 2D strain imaging software (GE Healthcare, Milwaukee, Wisconsin). Contraction was simulated from simultaneous segmental activation (Cvel=∞) through normal activation (Cvel=400cm/sec) to pacing Cvel (100 to 10cm/sec). The simulation generated average segmental strain-time waveforms for each velocity and peak strain as a function of Cvel and time to peak strain as a function of Cvel curves. RESULTS: With decreasing Cvel, average peak segmental strain was found to be decreased and delayed. The following correlation equation represents the correlation betweenpeak strain and Cvel : strain= -20.12+27.65 x e (-0.29 x Cvel). At the highest pacing Cvel (100cm/sec) average peak segmental strain dropped by 10%, at 50cm/sec by 30% and at the lowest pacing Cvel (10cm/sec) peak strain dropped by >90%. Time to peak segmental strain was minimally longer with decreasing Cvel down to 70cm/sec (pacing velocity range). Further decreased velocity dramatically increased time to peak strain of the simulated segment. CONCLUSIONS: The simulation yielded a predictive correlation between slower conduction velocities and decreased and delayed segmental strain.
PURPOSE: To simulate the effect of decreasing conduction velocity (Cvel) on average segmental myocardial strain using mathematical modeling. METHODS: The simulation was run using MatLab version 7.4 (The MathWorks, Inc. Natick, Massachusetts). A normal strain-time curve pattern was sampled from a normal human echo study using the 2D strain imaging software (GE Healthcare, Milwaukee, Wisconsin). Contraction was simulated from simultaneous segmental activation (Cvel=∞) through normal activation (Cvel=400cm/sec) to pacing Cvel (100 to 10cm/sec). The simulation generated average segmental strain-time waveforms for each velocity and peak strain as a function of Cvel and time to peak strain as a function of Cvel curves. RESULTS: With decreasing Cvel, average peak segmental strain was found to be decreased and delayed. The following correlation equation represents the correlation betweenpeak strain and Cvel : strain= -20.12+27.65 x e (-0.29 x Cvel). At the highest pacing Cvel (100cm/sec) average peak segmental strain dropped by 10%, at 50cm/sec by 30% and at the lowest pacing Cvel (10cm/sec) peak strain dropped by >90%. Time to peak segmental strain was minimally longer with decreasing Cvel down to 70cm/sec (pacing velocity range). Further decreased velocity dramatically increased time to peak strain of the simulated segment. CONCLUSIONS: The simulation yielded a predictive correlation between slower conduction velocities and decreased and delayed segmental strain.
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