Key result
In-silico models show normal myocardial fiber orientation maximizes LVEF while longer action potentials increase it.
Why the study?
The study investigated how LVEF behaves as a function of action potential duration in cardiomyocytes and myocardial fiber orientation in the ventricular wall.
In-silico modeling demonstrates that normal myocardial fiber orientation is optimized for maximal LVEF, and that action potential duration has a biphasic effect on ejection fraction.
Hypothesis-generating for electromechanical modeling; leaves open whether fiber orientation or APD modulation can be targeted to enhance LVEF.
The paper is devoted to a key indicator of the human cardiac performance, namely to the left ventricular ejection fraction (LVEF). The behavior of the LVEF as a function of two model features is investigated. Action potential duration (APD) in cardiomyocytes and myocardial fiber orientation in the ventricular wall were chosen as variable parameters that may influence on the ejection fraction. In our in-silico study, a simple electro-mechanical model of the human LV, that qualitatively reproduces electrophysiological and mechanical properties of the myocardium, is used. This work is performed using a population of models approach. It is observed that the parameters of fiber orientation in the structurally normal heart are near to optimal values providing for maximal cardiac performance. An increase in the action potential duration in a wide range leads to an increase in the ejection fraction, while there is an saturation point in the dependency, and a more significant increase in APD leads to the inverse effect.
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Sholokhov et al. (2020) studied Left ventricular ejection fraction. Action potential duration and myocardial fiber orientation was evaluated on Left ventricular ejection fraction (LVEF). In an in-silico model, myocardial fiber orientation in structurally normal hearts is near optimal for maximal LVEF, while increasing action potential duration increases LVEF up to a saturation point.
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