Myocardial ischemic effects on cardiac electro-mechanical activity

TL;DR

This study models how local ischemia, hyperkalemia, and hypoxia affect the electrical and mechanical behavior of cardiac tissue, revealing significant impacts on deformation and electro-mechanical coupling.

Contribution

It introduces a coupled electro-mechanical model of cardiac tissue incorporating ischemic effects, mechanical feedback, and stretch-activated channels, solved with finite element and finite difference methods.

Findings

Ischemic regions significantly alter cardiac action potential and calcium dynamics.

Expansion of ischemic regions causes up to 45% change in stretch rate.

Ischemia impacts heart deformation and contraction patterns.

Abstract

In this work, we investigated the effect of varying strength of Hyperkalemia and Hypoxia, in human cardiac tissue with a local ischemic subregion, on the electrical and mechanical activity of healthy and ischemic zones of the cardiac muscle. The Monodomain model in a deforming domain is taken with the addition of mechanical feedback and stretch-activated channel current coupled with the ten Tusscher human ventricular membrane model. The equations of finite elasticity are used to describe the deformation of the cardiac tissue. The resulting coupled electro-mechanical PDEs-ODEs non-linear system is solved numerically using finite elements in space and finite difference method in time. We examined the effect of local ischemia on cardiac electrical and mechanical activity in different cases. We concluded that the spread of Hyperkalemic or Hypoxic region alters the electro-mechanical coupling in terms of the action potential ($v$), intracellular calcium ion concentration $[Ca^{+2}]_i$, active tension, ($T_A$), stretch ($\lambda$), stretch rate ($ \frac{d \lambda}{dt}$). With the increase in the size of the ischemic region by a factor of five, approximately $45\%$ variation in the stretch rate $\frac{d \lambda}{dt}$ is noticed. It is also shown that ischemia affects the deformation (expansion and contraction) of the heart.