136061 20241125101200.0 doi 10.3389/fphys.2023.1060919 sideral 134882 ART-2023-134882 eng Bukhari, Hassaan A. (orcid)0000-0001-5976-0483 Differences in ventricular wall composition may explain inter-patient variability in the ECG response to variations in serum potassium and calcium 2023 Access copy available to the general public Unrestricted Objective: Chronic kidney disease patients have a decreased ability to maintain normal electrolyte concentrations in their blood, which increases the risk for ventricular arrhythmias and sudden cardiac death. Non-invasive monitoring of serum potassium and calcium concentration, [K + ] and [Ca 2+ ], can help to prevent arrhythmias in these patients. Electrocardiogram (ECG) markers that significantly correlate with [K + ] and [Ca 2+ ] have been proposed, but these relations are highly variable between patients. We hypothesized that inter-individual differences in cell type distribution across the ventricular wall can help to explain this variability.Methods: A population of human heart-torso models were built with different proportions of endocardial, midmyocardial and epicardial cells. Propagation of ventricular electrical activity was described by a reaction-diffusion model, with modified Ten Tusscher-Panfilov dynamics. [K + ] and [Ca 2+ ] were varied individually and in combination. Twelve-lead ECGs were simulated and the width, amplitude and morphological variability of T waves and QRS complexes were quantified.Results: Both simulations and patients data showed that most of the analyzed T wave and QRS complex markers correlated strongly with [K + ] (absolute median Pearson correlation coefficients, r, ranging from 0.68 to 0.98) and [Ca 2+ ] (ranging from 0.70 to 0.98). The same sign and similar magnitude of median r was observed in the simulations and the patients. Different cell type distributions in the ventricular wall led to variability in ECG markers that was accentuated at high [K + ] and low [Ca 2+ ], in agreement with the larger variability between patients measured at the onset of HD. The simulated ECG variability explained part of the measured inter-patient variability. info:eu-repo/grantAgreement/ES/DGA/LMP141-21 info:eu-repo/grantAgreement/ES/DGA/LMP94_21 info:eu-repo/grantAgreement/ES/DGA/T39-23R info:eu-repo/grantAgreement/ES/MICINN/PID2019-104881RB-I00 info:eu-repo/grantAgreement/ES/MICINN/PID2019-105674RB-I00 info:eu-repo/grantAgreement/ES/MICINN/PID2022-140556OB-I00 info:eu-repo/grantAgreement/EUR/MICINN/TED2021-130459B-I00 info:eu-repo/semantics/openAccess by http://creativecommons.org/licenses/by/3.0/es/ 3.2 2023 PHYSIOLOGY 24 / 85 = 0.282 2023 Q2 T1 1.006 2023 Physiology (medical) 2023 Q2 Physiology 2023 Q2 6.5 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sánchez, Carlos Universidad de Zaragoza (orcid)0000-0003-4273-5403 Laguna, Pablo Universidad de Zaragoza (orcid)0000-0003-3434-9254 Potse, Mark Pueyo, Esther Universidad de Zaragoza (orcid)0000-0002-1960-407X 5007 520 Universidad de Zaragoza Dpto. Informát.Ingenie.Sistms. Área Ingen.Sistemas y Automát. 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 14 (2023), 1060919 [14 pp.] Front. physiol. Frontiers in physiology 1664-042X 546184 http://zaguan.unizar.es/record/136061/files/texto_completo.pdf Versión publicada 2339774 http://zaguan.unizar.es/record/136061/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:136061 articulos driver 2024-11-22-12:11:12 ARTICLE