Suchergebnisse

[EN] Cardiovascular remodeling induced by intrauterine growth restriction manifests in adulthood by more globular ventricles, as evidenced by in vivo measurements. The angle between the dominant vectors of the QRS and T-wave loops has been reported to be significantly altered as a result of the induced remodeling. To investigate whether the more globular ventricular shape was a major factor contributing to such alteration, we performed electrophysiological simulations in a human biventricular model for control and in a model obtained by deforming the control one to represent a more spherical left ventricle (SLV). Transmural ventricular heterogeneities and a Purkinje network were included. 12-lead ECGs were calculated, from which spatial QRS and T-wave angles were computed. The angle between the T-wave and the XZ-plane was found to increase in the SLV model, showing a variation similar to that reported in in vivo studies. However, the angle between the dominant vectors of the QRS and T-wave loops projected onto the XY-plane was lower for control, contrary to clinical observations in IUGR adults. Other clinical results could not be reproduced in our simulations either. Our findings suggest that a more globular left ventricular shape leads to changes in the angles of QRS and T-wave loops, but further research is needed to fully understand these changes and the underlying mechanisms ; I would like to acknowledge support by Fundaci ' on Carolina, Universidad de Zaragoza and Universidad Polit ' ecnica Salesiana through its doctoral scholar-ship. This work was supported by projects ERC-StG 638284 (ERC), PID2019-105674RB-I00 and PID2019104881RB-I00 (MICINN) and LMP124-18 and reference group T39-20R (Arag ' on Government cofunded by FEDER 2014-2020 "Building Europe from Aragon"). Computations were performed using ICTS NANBIOSIS (HPC unit at U. Zaragoza). N. Ortigosa acknowledges support from Generalitat Valenciana under grant Prometeo/2017/102 and Spanish MINECO under grant MTM2016-76647-P ; Bueno-Palomeque, FL.; ...

611 621 56 4 ; S ; [EN] Cardiac resynchronization therapy (CRT) is an effective treatment for those patients with severe heart failure. Regrettably, there are about one third of CRT "non-responders", i.e. patients who have undergone this form of device therapy but do not respond to it, which adversely affects the utility and cost-effectiveness of CRT. In this paper, we assess the ability of a novel surface ECG marker to predict CRT response. We performed a retrospective exploratory study of the ECG previous to CRT implantation in 43 consecutive patients with ischemic (17) or non-ischemic (26) cardiomyopathy. We extracted the QRST complexes (consisting of the QRS complex, the S-T segment, and the T wave) and obtained a measure of their energy by means of spectral analysis. This ECG marker showed statistically significant lower values for non-responder patients and, joint with the duration of QRS complexes (the current gold-standard to predict CRT response), the following performances: 86% accuracy, 88% sensitivity, and 80% specificity. In this manner, the proposed ECG marker may help clinicians to predict positive response to CRT in a non-invasive way, in order to minimize unsuccessful procedures. This work was supported by MINECO under grants MTM2013-43540-P and MTM2016-76647-P. Ortigosa, N.; Pérez-Roselló, V.; Donoso, V.; Osca Asensi, J.; Martínez-Dolz, L.; Fernández Rosell, C.; Galbis Verdu, A. (2018). Early prediction of cardiac resynchronization therapy response by non-invasive electrocardiogram markers. Medical & Biological Engineering & Computing. 56(4):611-621. https://doi.org/10.1007/s11517-017-1711-1 Boggiatto P, Fernández C, Galbis A (2009) A group representation related to the stockwell transform. Indiana University Mathematics Journal 58(5):2277–2296 Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G et al (2013) 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy. Europace 15:1070–1118 Brown RA, Lauzon ML, Frayne R (2010) A general description of ...

[EN] Intrauterine Growth Restriction (IUGR) and premature birth are associated with higher risk of cardiovascular diseases throughout adulthood. The aim of this study was to evaluate the influence of these factors in ventricular electrical remodeling in preadolescents. Electrocardiography was performed in a cohort of 33-IUGR, 32-preterm with appropriate weight and 60 controls. Depolarization and repolarization processes were studied by means of the surface ECG, including loops and angles corresponding to QRS and T-waves. The angles between the dominant vector of QRS and the frontal plane XY were different among the study groups: controls [20.03 degrees(10.11 degrees-28.64 degrees)], preterm [25.48 degrees(19.79 degrees-33.56 degrees)], and IUGR [27.77 degrees(16.59 degrees-33.23 degrees)]. When compared to controls, IUGR subjects also presented wider angles between the difference of QRS and T-wave dominant vectors and the XY-plane [5.28 degrees +/- 12.15 degrees vs 0.49 degrees +/- 14.15 degrees, p 0.05] while preterm ones showed smaller frontal QRS-T angle [4.68 degrees(2.20 degrees-12.89 degrees) vs 6.57 degrees(2.72 degrees-11.31 degrees), p 0.05]. Thus, electrical remodeling is present in IUGR and preterm preadolescents, and might predispose them to cardiovascular diseases in adulthood. Follow-up studies are warranted. (C) 2016 Elsevier Inc. All rights reserved. ; N.Ortigosa acknowledgesthe support fromGeneralitatValenciana under grants PrometeoII/2013/013, ACOMP/2015/186, and MINECO under grant MTM2013-43540-P. This project has also been partially funded by TEC2013-42140-R and TIN2014-53567-R from CICYT, by Grupo Consolidado BSICoS from DGA (Aragon) and European Social Fund, the Erasmus + Program of the European Union (Framework Agreement number: 2013-0040), the South -Eastern Norway Regional Health Authority, the Bergesen foundation and grants from Instituto de Salud Carlos III (grant numbers PI12/00801 and PI14/00226); Ministerio de Economia y Competitividad (grant number SAF2012-37196), cofinanced by the ...