跳动心脏的心电仿真模型建构

以往的心电仿真研究都没有考虑在一个心动周期内,因为心脏跳动而引起的偶极子位置变化的实际情况,从而造成其结果输出的不可避免的误差,在心脏电生理和心脏动力学分析的基础上,对原有的心脏电仿真模型施加动力学影响,从而构建了新的跳动心脏模型。在这两个模型上进行了正常心脏和心肌缺血心脏的仿真试验后,对比两个心电模型的仿真输出,发现新的心脏模型有效提高了仿真精度,对于严重心肌缺血和轻微心肌缺血的识别分别有不同程度的改善。这项研究证实了动力学因素 在心电模型建构中的重要性,为心电正问题和逆问题研究的进一步开展 提供了新的思路和方向。     

心脏电活动的计算机仿真模型

一、前言 自从100多年前人们发现体表心电以来在心脏电生理学方面和心电诊断学方面进行了大量的研究和临床的实践。尤其是心脏电生理学方面的研究十分细致、深入。从心肌细胞的电生理特性到细胞的除极和复极。以致兴奋在整个心脏中的传播机理和过程等都进行了很仔细的研究。另一方面,心电诊断学的发展相对比较粗糙和缓慢。究其原因,可以认     

基于心脏电生理模型的心律失常机制研究进展

揭示发病机制是心律失常诊断、治疗、药物研发和设备设计的关键.整合当前在心脏分子生物学、生物化学、生理学及解剖学方面的最新成果,构建从离子通道、心肌细胞、心肌纤维、心肌组织、心脏器官到躯体各个层次的多尺度多模态心脏电生理模型,用于系统研究微观局部变化发生、发展、转化为宏观心律失常表现的过程,将彻底改变传统从基因突变、蛋白质表达、细胞电生理、临床表现单独研究心律失常的方式,实现微观与宏观研究的统一,使心脏电生理模型成为系统研究心律失常发病机制的有力手段.本文综述了心脏电生理模型的构建方法和研究进展,讨论了多尺度心脏电生理模型在揭示心律失常机制研究中的作用和地位,给出了基于心脏电生理模型心律失常研究的挑战和重要发展方向.     

有限元法计算各向异性介质球头模型电位分布

在脑电正问题研究中,脑神经元所产生的电活动可用电流偶极子来模拟.本文提出把大脑看作各向异性介质球,即同时考虑电容效应、电导效应对脑内电流偶极子产生的电位的影响,并用有限元法推导出偶极子在各向异性介质球模型中的电位分布计算公式.结果表明介质的电容效应对电位分布是有影响的,反映了大脑活组织电特性,对外来不同频率的信号刺激有不同的响应.同时有限元法对大脑内某一区域内电位分布求解表明,测量较深层组织的电特性变化敏感的特点,可获得更多的测量信息.     

A training whole-heart model for simulating propagation and ECG patterns

The forward problem of electrocardiography describes the spatio-temporal source–field relationship generating the body surface potential (BSP) and, thus, the electrocardiogram (ECG). The paper presents a ventricular and atrial model for simulating cardiac de- and repolarization and the P-, QRS- and T-wave. The atria and the ventricles are coupled, so that electroanatomical function can be simulated at ones. Movement and contraction are not taken into account while an individual geometry, fibre architecture and ECG sensor arrangement including the Wilson central terminal (WCT) as common reference were considered. This in silico whole-heart model can be used for detailed investigations of the nature of the ECG for the normal beat, arrhythmias, ischemia and infarction. In addition, this model was used as a reference tool for developing and testing different electrocardiographic inverse approaches.     

Noninvasive detection of epicardial and endocardial activity of the heart

Determining electrical activation of the heart in a noninvasive way is one of the challenges in cardiac electrophysiology. The ECG provides some, but limited information about the electrical status of the heart. This article describes a method to determine both endocardial and epicardial activation of the heart of an individual patient from 64 electrograms recorded from the body surface. Information obtained in this way might be helpful for the treatment of arrhythmias, to assess the effect of drugs on conduction in the heart and to assess electrical stability of the heart.     

人体躯干模型中肺的存在对体表电位分布的影响

在所建三维人体躯干模型的基础上,给出了如何应用边界元方法对非均匀人体场域进行求解。在设定心外膜电位分别呈现为单偶极子和双偶极子时,求出相应非均匀场域中的体表电位分布,并将它们与相同情况下均匀场域的体表电位分布进行分析比较。结果表明：躯干模型中肺的存在虽然对体表电位中极值的大小和位置没有太大影响,但却较大程序地改变了整个体表电位的分布状况,具体地说,就是由于肺的存在使得体表电位值较均匀时的相对误差高     

Liquid chromatographic assay with fluorescence detection to determine ajmaline in serum from patients with suspected Brugada syndrome

Ajmaline is a sodium channel blocking, class 1A anti-arrhythmic drug. It has gained renewed interest in the field of cardiology as a diagnostic agent to reveal the electrocardiographic characteristics in patients with suspected Brugada syndrome. We developed a simple and precise high-performance liquid chromatographic assay to determine ajmaline in serum of patients. The samples were pre-treated using protein precipitation with perchloric acid and the extract was injected into the chromatographic system. The system consisted of an end-capped octadecyl silica column with isocratic elution using perchloric acid in a water-acetonitrile mixture. Ajmaline was detected by fluorescence at 290 and 355 nm for excitation and emission, respectively. The assay was validated in a 21-5300 ng/ml concentration range, the lower limit of quantification was 25 ng/ml. Within day precisions were 1.3-3.9%, between day precisions 2-7% and accuracies were between 95 and 99% for the whole calibration range. The drug was shown to be chemically stable under all relevant conditions. This assay has been successfully applied to pharmacokinetic-pharmacodynamic evaluations of intravenous ajmaline administration to patients with suspected Brugada syndrome.     

类α-蝎神经毒素BmKⅠ对离体大鼠心脏收缩力及电活动的特异调控

本研究探讨了一种特异性钠通道调制剂(Buthusmartensi Karsch,BmKⅠ)对离体大鼠心脏收缩力及电活动的调制作用.离体心脏灌流实验显示(1)BmKⅠ(0.5-10μmol/L)剂量依赖地增强大鼠心肌收缩力,左心室最大发展压(LVDPmax)以及dp/dtmax与对照组相比均显著增强(n=6,P＜0.05),同时可触发正性变时作用(n=6,P＜0.05);(2)大剂量BmKⅠ(20μmol/L)引起负性肌力作用及心动过缓;(3)冠脉流量随心脏收缩力的增强反而减小,应用500nmol/LBmKⅠ时冠脉流量由14.5 ml/min降至8.6 ml/min(n=6,P＜0.05);此外,心电图记录表明BmKⅠ(0.5-10μmol/L)可触发心动过速及复杂的心律失常等电活动变化;正常灌流液洗脱后BmKI引起的大鼠心脏收缩力及电活动的改变可部分恢复.由于β-肾上腺素能受体阻滞剂普奈洛尔预先应用抑制了儿茶酚胺类神经递质的释放,提示BmKⅠ引起的大鼠心脏收缩力及电活动的改变不是由于其调节儿茶酚胺类神经递质的释放及随后β-肾上腺素能受体的激活,而可能与其对心肌电压门控钠通道的调控有关.     

多种无创检查组合在冠心病诊断中的价值

目的：评价多种无创辅助检查组合对冠状动脉粥样硬化性心脏病（冠心病）辅助诊断价值,筛选有效的冠心病确诊和排除指标,初步确定优化的冠心病早期诊断策略。方法：回顾性分析6419例冠心病患者多项无创辅助检查结果（包括静息心电图、24小时动态心电图、负荷心电图、负荷核素心肌显像、16或64排CT冠状动脉成像）,以冠状动脉造影阳性（至少一支主要冠状动脉或其主要分支的内径有≥50％的狭窄）为金标准,观察各种无创辅助检查组合对冠心病诊断的特异性、敏感性、误诊率、漏诊率、阳性预测值和阴性预测值。结果：多项无创辅助检查组合在冠心病的诊断中敏感性56．02-87．43％,特异36．13-87．61％,阳性预测值58．83．97．16％,阴性预测值30．21．73．36％,非介入手段中,敏感性和阴性预测值以动态心电图联合核素心肌灌注显像组最高,特异性和阳性预测值以动态心电图联合冠脉CT成像组最高。结论：辅助检查组合可作为无创性诊断、评价冠心病的重要方法,动态心电图可作为各级别医院冠心病筛查的基本及重要手段。     

Resveratrol, a natural ingredient of grape skin: antiarrhythmic efficacy and ionic mechanisms

Resveratrol has been demonstrated to produce a variety of biological actions. Accumulating line of evidence supported the view that resveratrol may exert protective effect on the cardiovascular system. The aim of the study was to assess the antiarrhythmic profile as well as electrophysiological properties of resveratrol. We observe the antiarrhythmic effect of resveratrol on aconitine induced rat arrhythmia, ouabain induced guinea pig arrhythmia, and coronary ligation induced rat arrhythmia animal models. Resveratrol significantly and dose-dependently increased the doses of aconitine and ouabain required to induce the arrhythmia indexes. In coronary ligation induced rat arrhythmia model, resveratrol shortened duration of arrhythmia, decreased incidence of ventricular tachycardia and mortality. Electrophysiological experiment revealed that resveratrol could shorten APD through inhibition of ICa and selective enhancement of IKs without an effect on IKr.