Image-based modeling of acute myocardial ischemia using experimentally derived ischemic zone source representations

• Published in: Journal of Electrocardiology Vol. 51; no. 4; pp. 725 - 733
• Main Authors: Burton, B.M., Aras, K.K., Good, W.W., Tate, J.D., Zenger, B., MacLeod, R.S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2018; Elsevier BV
• Subjects: Acute Disease; Animals; Border zone; Computer modeling; Computer Simulation; Disease Models, Animal; Dogs; Electrocardiography; Ischemic zone; Models, Cardiovascular; Myocardial Ischemia; Myocardial Ischemia - physiopathology; ST deviation; Subject-specific modeling; Ischemic zone; Myocardial ischemia; Subject-specific modeling; ST deviation; Computer modeling; Border zone
• ISSN: 0022-0736; 1532-8430; 1532-8430
• DOI: 10.1016/j.jelectrocard.2018.05.005

Computational models of myocardial ischemia often use oversimplified ischemic source representations to simulate epicardial potentials. The purpose of this study was to explore the influence of biophysically justified, subject-specific ischemic zone representations on epicardial potentials. We developed and implemented an image-based simulation pipeline, using intramural recordings from a canine experimental model to define subject-specific ischemic regions within the heart. Static epicardial potential distributions, reflective of ST segment deviations, were simulated and validated against measured epicardial recordings. Simulated epicardial potential distributions showed strong statistical correlation and visual agreement with measured epicardial potentials. Additionally, we identified and described in what way border zone parameters influence epicardial potential distributions during the ST segment. From image-based simulations of myocardial ischemia, we generated subject-specific ischemic sources that accurately replicated epicardial potential distributions. Such models are essential in understanding the underlying mechanisms of the bioelectric fields that arise during ischemia and are the basis for more sophisticated simulations of body surface ECGs. •Experiments show that myocardial ischemia develops as complex distributed regions rather than simple subendocardial zones.•We characterized these experimental findings and used them to develop a subject-specific simulation pipeline.•We identified how border zone parameters influence simulated solutions in translating, scaling, and refining model outcomes.•Results from our pipeline correlate strongly with measured epicardial potentials. [Display omitted]