Dependence of temporal variability of ventricular recovery on myocardial fibrosis. Role of mechanoelectric feedback?

doi:10.1016/S0008-6363(97)00221-6

Cardiovascular Research 1998 37(1):58-65; doi:10.1016/S0008-6363(97)00221-6
© 1998 by European Society of Cardiology

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Dependence of temporal variability of ventricular recovery on myocardial fibrosis. Role of mechanoelectric feedback?

Donatella Stilli^a^,*, Beatrice Aimi^a, Andrea Sgoifo^a, Patrizia Ciarlini^b, Giuseppe Regoliosi^b, Costanza Lagrasta^c, Giorgio Olivetti^c and Ezio Musso^a

^aDipartimento di Biologia Evolutiva e Funzionale - Sezione Fisiologia, Università degli Studi di Parma, Viale delle Scienze, Parma 43100, Italy
^bIstituto per le Applicazioni del Calcolo "Mauro Picone", CNR, Via del Policlinico 136, Roma 00161, Italy
^cIstituto di Anatomia Patologica, Università degli Studi di Parma, Via A. Gramsci 14, Parma 43100, Italy

^* Corresponding author. Tel. +39-521-905625; Fax +39-521-905673.

Objective: The study was aimed at establishing the effect offactors involved in the expression of mechanoelectric feedbackin the heart, such as R-R interval and connective tissue, ontime dependent changes in ventricular recovery, as determinedat the body surface by beat to beat variability of QRST integralmaps (BBV-IM). Methods: We used 15 normal 6-month-old Wistarrats. In each anesthetized animal, we performed a 3-minute continuousrecording of 44 simultaneous chest ECGs. The signals were interactivelyprocessed, 1) to determine mean R-R interval and R-R variabilitythroughout the recording period and 2) to compute QRST integralmaps from approximately 50 beats belonging to the end of expiration.Then BBV-IM was calculated and expressed as percentage of beatssignificantly differing from a template. At sacrifice, the amountof myocardial fibrosis was morphometrically evaluated. Results:R-R interval was 149 ms±4, R-R interval variability 0.008±0.001and BBV-IM 30.7%±4.4. Myocardial fibrosis expressed as% volume of left ventricular myocardium, numerical density offibrotic foci and average cross-sectional area of the foci was3.0%±0.4, 3.8±0.6 and 4.4 µm²/1000±0.1respectively. BBV-IM was positively correlated to the % volumeof fibrosis (r = 0.81, P<0.0003). Both measurements werepositively correlated to R-R interval (BBV-IM: r = 0.83, P<0.0001;% volume of fibrosis: r = 0.87, P<0.0001) and negativelycorrelated to cardiac weights (BBV-IM: r = –0.79, P<0.0005;% volume of fibrosis: r = –0.75, P<0.001). Conclusion:Beat to beat changes in ventricular repolarization attributableto mechanoelectric transduction can be detected at the bodysurface by means of BBV-IM.

KEYWORDS Repolarization; Mechanoelectric feedback; Integral maps; Non-invasive measurements; Myocardial fibrosis; Cycle length; Heart rate variability; Rat, anesthetized

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