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Pearce NF, Turner MC, Maddock HL, Kim EJ. Development of a novel low-order model for atrial function and a study of atrial mechano-electric feedback. Comput Biol Med 2023; 159:106697. [PMID: 37087301 DOI: 10.1016/j.compbiomed.2023.106697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Numerical models of the cardiovascular system have largely focused on the function of the ventricles, with atrial function often neglected. Furthermore, the time-varying elastance method that prescribes the pressure-volume relationship rather than calculating it consistently is frequently used for the ventricles and atrium. This method has yet to be validated however, so its applicability for cardiac modelling is frequently questioned. To overcome this challenge, we propose a synergistic model of left atrium (LA) and left ventricle (LV) by self-consistently integrating various feedback mechanisms among the electro-mechanical and chemical functions of the micro-scale myofiber, the macro-scale dynamics of the LA and LV, the atrioventricular node (AV), and circulation. The model is tested and shown to reproduce the essential features of the atrium cycling, such as the characteristic figure of eight pressure-volume loops. Our model is further developed to investigate the effect of dysfunctions of the mechanical-electric feedback (MEF) in the atrium. Our model not only successfully reproduces key experimental MEF observations such as prolonged action-potential and increases in action-potential magnitude induced by atrial stretch but also shows how MEF and arrhythmia of the atrium lead to a degradation of cardiac output and pumping power with significant consequences. In particular, MEF reproduces arrhythmia such as ectopic and erratic cycling, missed heart beats and restricted function.
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Affiliation(s)
- Nicholas F Pearce
- Fluids and Complex Systems Center, Faculty of Engineering, Environment and Computing, Coventry University, Coventry, CV1 5FB, UK.
| | - Mark C Turner
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health and Well-being, Coventry University, Coventry, CV1 5FB, UK
| | - Helen L Maddock
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health and Well-being, Coventry University, Coventry, CV1 5FB, UK
| | - Eun-Jin Kim
- Fluids and Complex Systems Center, Faculty of Engineering, Environment and Computing, Coventry University, Coventry, CV1 5FB, UK
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Quinn TA, Kohl P. Cardiac Mechano-Electric Coupling: Acute Effects of Mechanical Stimulation on Heart Rate and Rhythm. Physiol Rev 2020; 101:37-92. [PMID: 32380895 DOI: 10.1152/physrev.00036.2019] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The heart is vital for biological function in almost all chordates, including humans. It beats continually throughout our life, supplying the body with oxygen and nutrients while removing waste products. If it stops, so does life. The heartbeat involves precise coordination of the activity of billions of individual cells, as well as their swift and well-coordinated adaption to changes in physiological demand. Much of the vital control of cardiac function occurs at the level of individual cardiac muscle cells, including acute beat-by-beat feedback from the local mechanical environment to electrical activity (as opposed to longer term changes in gene expression and functional or structural remodeling). This process is known as mechano-electric coupling (MEC). In the current review, we present evidence for, and implications of, MEC in health and disease in human; summarize our understanding of MEC effects gained from whole animal, organ, tissue, and cell studies; identify potential molecular mediators of MEC responses; and demonstrate the power of computational modeling in developing a more comprehensive understanding of ‟what makes the heart tick.ˮ.
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Affiliation(s)
- T Alexander Quinn
- Department of Physiology and Biophysics and School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Medical Faculty of the University of Freiburg, Freiburg, Germany; and CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - Peter Kohl
- Department of Physiology and Biophysics and School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada; Institute for Experimental Cardiovascular Medicine, University Heart Centre Freiburg/Bad Krozingen, Medical Faculty of the University of Freiburg, Freiburg, Germany; and CIBSS-Centre for Integrative Biological Signalling Studies, University of Freiburg, Freiburg, Germany
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Thanigaimani S, McLennan E, Linz D, Mahajan R, Agbaedeng TA, Lee G, Kalman JM, Sanders P, Lau DH. Progression and reversibility of stretch induced atrial remodeling: Characterization and clinical implications. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2017; 130:376-386. [PMID: 28734850 DOI: 10.1016/j.pbiomolbio.2017.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/17/2017] [Accepted: 07/18/2017] [Indexed: 12/13/2022]
Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia and across the developed nations, it contributes to increasing hospitalizations and healthcare burden. Several comorbidities and risk factors including hypertension, heart failure, obstructive sleep apnoea and obesity are known to play an important role in the initiation and perpetuation of AF and atrial stretch or dilatation may play a central mechanistic role. The impact of atrial stretch in the development of AF can vary dependent on the underlying disease. This review focuses on understanding the substrate for AF in conditions of acute and chronic stretch and in the presence of common co-morbidities or risk factors through the review of findings in both animal and human studies. Additionally, the reversibility of atrial remodeling following stretch release will also be discussed. Identification of clinical conditions associated with increased atrial stretch as well as the treatment or prevention of these conditions may help to prevent AF progression and improve sinus rhythm maintenance.
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Affiliation(s)
- Shivshankar Thanigaimani
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Emma McLennan
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dominik Linz
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Rajiv Mahajan
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Thomas A Agbaedeng
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Geoffrey Lee
- Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jonathan M Kalman
- Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dennis H Lau
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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Walters TE, Lee G, Spence S, Larobina M, Atkinson V, Antippa P, Goldblatt J, O’Keefe M, Sanders P, Kistler PM, Kalman JM. Acute Atrial Stretch Results in Conduction Slowing and Complex Signals at the Pulmonary Vein to Left Atrial Junction. Circ Arrhythm Electrophysiol 2014; 7:1189-97. [DOI: 10.1161/circep.114.001894] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tomos E. Walters
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Geoffrey Lee
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Steven Spence
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Marco Larobina
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Victoria Atkinson
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Phillip Antippa
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - John Goldblatt
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Michael O’Keefe
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Prashanthan Sanders
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Peter M. Kistler
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
| | - Jonathan M. Kalman
- From the Department of Cardiology (T.E.W., G.L., S.S., J.M.K.) and Department of Cardiothoracic Surgery (M.L., V.A., P.A., J.G., M.O.K.), Royal Melbourne Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia (T.E.W., G.L., P.M.K., J.M.K.); Centre for Heart Rhythm Disorder, University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, Australia (P.S.); and Department of Cardiology, Alfred Hospital and Baker IDI, Melbourne,
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