Accuracy of prediction of infarct-related arrhythmic circuits from image-based models reconstructed from low and high resolution MRI.

Identification of optimal ablation sites in hearts with infarct-related ventricular tachycardia (VT) remains difficult to achieve with the current catheter-based mapping techniques. Limitations arise from the ambiguities in determining the reentrant pathways location(s). The goal of this study was to develop experimentally validated, individualized computer models of infarcted swine hearts, reconstructed from high-resolution ex-vivo MRI and to examine the accuracy of the reentrant circuit location prediction when models of the same hearts are instead reconstructed from low clinical-resolution MRI scans. To achieve this goal, we utilized retrospective data obtained from four pigs ~10 weeks post infarction that underwent VT induction via programmed stimulation and epicardial activation mapping via a multielectrode epicardial sock. After the experiment, high-resolution ex-vivo MRI with late gadolinium enhancement was acquired. The Hi-res images were downsampled into two lower resolutions (Med-res and Low-res) in order to replicate image quality obtainable in the clinic. The images were segmented and models were reconstructed from the three image stacks for each pig heart. VT induction similar to what was performed in the experiment was simulated. Results of the reconstructions showed that the geometry of the ventricles including the infarct could be accurately obtained from Med-res and Low-res images. Simulation results demonstrated that induced VTs in the Med-res and Low-res models were located close to those in Hi-res models. Importantly, all models, regardless of image resolution, accurately predicted the VT morphology and circuit location induced in the experiment. These results demonstrate that MRI-based computer models of hearts with ischemic cardiomyopathy could provide a unique opportunity to predict and analyze VT resulting for from specific infarct architecture, and thus may assist in clinical decisions to identify and ablate the reentrant circuit(s)

Submillimeter diffusion tensor imaging and late gadolinium enhancement cardiovascular magnetic resonance of chronic myocardial infarction.

BackgroundKnowledge of the three-dimensional (3D) infarct structure and fiber orientation remodeling is essential for complete understanding of infarct pathophysiology and post-infarction electromechanical functioning of the heart. Accurate imaging of infarct microstructure necessitates imaging techniques that produce high image spatial resolution and high signal-to-noise ratio (SNR). The aim of this study is to provide detailed reconstruction of 3D chronic infarcts in order to characterize the infarct microstructural remodeling in porcine and human hearts.MethodsWe employed a customized diffusion tensor imaging (DTI) technique in conjunction with late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) on a 3T clinical scanner to image, at submillimeter resolution, myofiber orientation and scar structure in eight chronically infarcted porcine hearts ex vivo. Systematic quantification of local microstructure was performed and the chronic infarct remodeling was characterized at different levels of wall thickness and scar transmurality. Further, a human heart with myocardial infarction was imaged using the same DTI sequence.ResultsThe SNR of non-diffusion-weighted images was >100 in the infarcted and control hearts. Mean diffusivity and fractional anisotropy (FA) demonstrated a 43% increase, and a 35% decrease respectively, inside the scar tissue. Despite this, the majority of the scar showed anisotropic structure with FA higher than an isotropic liquid. The analysis revealed that the primary eigenvector orientation at the infarcted wall on average followed the pattern of original fiber orientation (imbrication angle mean: 1.96 ± 11.03° vs. 0.84 ± 1.47°, p = 0.61, and inclination angle range: 111.0 ± 10.7° vs. 112.5 ± 6.8°, p = 0.61, infarcted/control wall), but at a higher transmural gradient of inclination angle that increased with scar transmurality (r = 0.36) and the inverse of wall thickness (r = 0.59). Further, the infarcted wall exhibited a significant increase in both the proportion of left-handed epicardial eigenvectors, and in the angle incoherency. The infarcted human heart demonstrated preservation of primary eigenvector orientation at the thinned region of infarct, consistent with the findings in the porcine hearts.ConclusionsThe application of high-resolution DTI and LGE-CMR revealed the detailed organization of anisotropic infarct structure at a chronic state. This information enhances our understanding of chronic post-infarction remodeling in large animal and human hearts

Dynamics of lattice spins as a model of arrhythmia

We consider evolution of initial disturbances in spatially extended systems with autonomous rhythmic activity, such as the heart. We consider the case when the activity is stable with respect to very smooth (changing little across the medium) disturbances and construct lattice models for description of not-so-smooth disturbances, in particular, topological defects; these models are modifications of the diffusive XY model. We find that when the activity on each lattice site is very rigid in maintaining its form, the topological defects - vortices or spirals - nucleate a transition to a disordered, turbulent state.Comment: 17 pages, revtex, 3 figure

Morphometric, quantitative and population characteristics oF Rapana venosa (Valenciennes, 1846) in front of Pasha Dere

A total of 468 individuals of the rapa whelk (Rapana venosa) were studied in terms of size, weight and sex in the sea area in front of Pasha dere (south of Varna Bay, Black Sea) in the summer of 2016. Sampling was performed by bottom trawling on three transects at different depths (from 9.0 m to 24.5 m) and different type of substrate (sand, sandy silt and silt). In the present study the average length was 6.36 cm and the absolute shell length ranged from a minimum of 3.24 cm to a maximum of 9.68 cm. The established average total weight was 47.31 g, its absolute value ranging from 9.98 g to 135.02 g. The average values of the shell length and total weight of the rapa whelk were the lowest on shallow sandy bottom (6.01 cm and 41.94 g, respectively) and the highest at 21 m depth on silty sediments (6.84 cm and 55.13 g, respectively). The size-weight relationship between all individuals was described by the formula W = 0.248L2.797 (R2 = 0.937), with the allometric coefficient (b) ranging from 2.817 to 3.066. On the sandy sediment, the male: female ratio was 2:1; in sandy silt, the percentages of male and female specimens were 55% and 45% respectively, and in silty sediment the sex ratio was 1:1. The male specimens were characterized by higher values of all morphometric parameters compared to the females. In the size distribution of sexes, the highest was the frequency of the males in size class of 6-7 cm, and the females with 5-6 cm shell length. In the weight distribution of the males, the individuals with total weight in the range 30-40 g dominated, while the prevailing female individuals weighed between 20 g and 30 g

Improved Hybrid/GPU Algorithm for Solving Cardiac Electrophysiology Problems on Purkinje Networks

Cardiac Purkinje fibres provide an important pathway to the coordinated contraction of the heart. We present a numerical algorithm for the solution of electrophysiology problems across the Purkinje network that is efficient enough to be used in in-silico studies on realistic Purkinje networks with physiologically detailed models of ion exchange at the cell membrane. The algorithm is based on operator splitting and is provided with three different implementations: pure CPU, hybrid CPU/GPU, and pure GPU. Compared to our previous work, we modify the explicit gap junction term at network bifurcations in order to improve its mathematical consistency. Due to this improved consistency of the model, we are able to perform an empirical convergence study against analytical solutions. The study verified that all three implementations produce equivalent convergence rates, which shows that the algorithm produces equivalent result across different hardware platforms. Finally, we compare the efficiency of all three implementations on Purkinje networks of increasing spatial resolution using membrane models of increasing complexity. Both hybrid and pure-GPU implementations outperform the pure-CPU implementation, but their relative performance difference depends on the size of the Purkinje network and the complexity of the membrane model used