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Protective role of false tendon in subjects with left bundle branch block: a virtual population study

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dc.contributor.author Lange, Matthias
dc.contributor.author Di Marco, LY
dc.contributor.author Lekadir, Karim, 1977-
dc.contributor.author Lassila, Toni
dc.contributor.author Frangi Caregnato, Alejandro
dc.date.accessioned 2024-02-19T10:09:13Z
dc.date.available 2024-02-19T10:09:13Z
dc.date.issued 2016
dc.identifier.citation Lange M, Di Marco LY, Lekadir K, Lassila T, Frangi AF. Protective role of false tendon in subjects with left bundle branch block: a virtual population study. PLoS ONE. 2016 Jan 14;11(1):e0146477. DOI: 10.1371/journal.pone.0146477
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10230/59144
dc.description.abstract False tendons (FTs) are fibrous or fibromuscular bands that can be found in both the normal and abnormal human heart in various anatomical forms depending on their attachment points, tissue types, and geometrical properties. While FTs are widely considered to affect the function of the heart, their specific roles remain largely unclear and unexplored. In this paper, we present an in silico study of the ventricular activation time of the human heart in the presence of FTs. This study presents the first computational model of the human heart that includes a FT, Purkinje network, and papillary muscles. Based on this model, we perform simulations to investigate the effect of different types of FTs on hearts with the electrical conduction abnormality of a left bundle branch block (LBBB). We employ a virtual population of 70 human hearts derived from a statistical atlas, and run a total of 560 simulations to assess ventricular activation time with different FT configurations. The obtained results indicate that, in the presence of a LBBB, the FT reduces the total activation time that is abnormally augmented due to a branch block, to such an extent that surgical implant of cardiac resynchronisation devices might not be recommended by international guidelines. Specifically, the simulation results show that FTs reduce the QRS duration at least 10 ms in 80% of hearts, and up to 45 ms for FTs connecting to the ventricular free wall, suggesting a significant reduction of cardiovascular mortality risk. In further simulation studies we show the reduction in the QRS duration is more sensitive to the shape of the heart then the size of the heart or the exact location of the FT. Finally, the model suggests that FTs may contribute to reducing the activation time difference between the left and right ventricles from 12 ms to 4 ms. We conclude that FTs may provide an alternative conduction pathway that compensates for the propagation delay caused by the LBBB. Further investigation is needed to quantify the clinical impact of FTs on cardiovascular mortality risk.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Public Library of Science (PLoS)
dc.relation.ispartof PLoS ONE. 2016 Jan 14;11(1):e0146477
dc.rights © 2016 Lange et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject.other Tendons
dc.subject.other Cor
dc.subject.other Cirurgia
dc.title Protective role of false tendon in subjects with left bundle branch block: a virtual population study
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0146477
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion

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