title: Antenatal architecture and activity of the human heart.
abstract: We construct the components for a family of computational models of the electrophysiology of the human foetal heart from 60 days gestational age (DGA) to full term. This requires both cell excitation models that reconstruct the myocyte action potentials, and datasets of cardiac geometry and architecture. Fast low-angle shot and diffusion tensor magnetic resonance imaging (DT-MRI) of foetal hearts provides cardiac geometry with voxel resolution of approximately 100 µm. DT-MRI measures the relative diffusion of protons and provides a measure of the average intravoxel myocyte orientation, and the orientation of any higher order orthotropic organization of the tissue. Such orthotropic organization in the adult mammalian heart has been identified with myocardial sheets and cleavage planes between them. During gestation, the architecture of the human ventricular wall changes from being irregular and isotropic at 100 DGA to an anisotropic and orthotropic architecture by 140 DGA, when it has the smooth, approximately 120° transmural change in myocyte orientation that is characteristic of the adult mammalian ventricle. The DT obtained from DT-MRI provides the conductivity tensor that determines the spread of potential within computational models of cardiac tissue electrophysiology. The foetal electrocardiogram (fECG) can be recorded from approximately 60 DGA, and RR, PR and QT intervals between the P, R, Q and T waves of the fECG can be extracted by averaging from approximately 90 DGA. The RR intervals provide a measure of the pacemaker rate, the QT intervals an index of ventricular action potential duration, and its rate-dependence, and so these intervals constrain and inform models of cell electrophysiology. The parameters of models of adult human sinostrial node and ventricular cells that are based on adult cell electrophysiology and tissue molecular mapping have been modified to construct preliminary models of foetal cell electrophysiology, which reproduce these intervals from fECG recordings. The PR and QR intervals provide an index of conduction times, and hence propagation velocities (approx. 1-10 cm s(-1), increasing during gestation) and so inform models of tissue electrophysiology. Although the developing foetal heart is small and the cells are weakly coupled, it can support potentially lethal re-entrant arrhythmia.
authors.affiliation: School of Biomedical Sciences , University of Leeds , Leeds LS2 9JT , UK.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Pervolaraki
authors.affiliation: MRC Centre for Reproductive Health , University of Edinburgh , Edinburgh EH16 4T3 , UK.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: School of Biomedical Sciences , University of Leeds , Leeds LS2 9JT , UK.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Benson
authors.affiliation: Department of Electrical and Electronic Engineering , University of Nottingham , Nottingham NG7 2RD , UK.
authors.forename: Barrie
authors.initials: B
authors.lastname: Hayes-Gill
authors.affiliation: School of Biomedical Sciences , University of Leeds , Leeds LS2 9JT , UK.
authors.forename: Arun V
authors.initials: AV
authors.lastname: Holden
authors.affiliation: School of Biomedical Sciences , University of Leeds , Leeds LS2 9JT , UK.
authors.forename: Benjamin J R
authors.initials: BJ
authors.lastname: Moore
authors.affiliation: Department of Cardiovascular Science , University of Sheffield Medical School , Sheffield S10 2RX , UK.
authors.forename: Martyn N
authors.initials: MN
authors.lastname: Paley
authors.affiliation: Department of Physics and Astronomy , University of Manchester , Manchester M13 9PL , UK.
authors.forename: Henggui
authors.initials: H
authors.lastname: Zhang
keywords: cardiac electrophysiology; computational modelling; diffusion tensor magnetic resonance imaging; foetal ECG; foetal heart development; myocardial architecture