title: Transmural, interventricular, apicobasal and anteroposterior action potential duration gradients are all essential to the genesis of the concordant and realistic T wave: A whole-heart model study.
abstract: It has been reported that ventricular repolarization dispersion resulting from transmural, apicobasal and interventricular action potential duration (APD) gradients makes the T wave concordant with the QRS complex.
  
  
  
  A whole-heart model integrating transmural, apicobasal, interventricular and anteroposterior APD gradients was used, and the corresponding electrocardiograms were simulated to study the influence of these APD gradients on the T-wave amplitudes. The simulation results showed that changing a single APD gradient (e.g., interventricular APD gradient alone) only made substantial changes to the T-wave amplitudes in a limited number of leads and was not able to generate T waves with amplitudes comparable with clinical findings in all leads. A combination of transmural, apicobasal and interventricular APD gradients could simulate T waves with amplitudes similar to clinical values in the limb leads only. Adding the anteroposterior APD gradient into the model greatly improved the consistency between the simulated T-wave amplitudes and the clinical values.
  
  
  
  The simulation results support that the transmural, apicobasal, interventricular and the anteroposterior APD gradient are all essential to the genesis of the clinical T wave.
authors.affiliation: Biomedical Information Technology Lab, the University of Aizu, Tsuruga, Ikki-machi, Aizu-Wakamatsu, Fukushima, Japan.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Seiryo-Machi 1-1, Aoba-ku, Sendai, Miyagi, Japan. Electronic address: daming.wei@ekgtechnol.com.
authors.forename: Daming
authors.initials: D
authors.lastname: Wei
authors.affiliation: Biomedical Information Technology Lab, the University of Aizu, Tsuruga, Ikki-machi, Aizu-Wakamatsu, Fukushima, Japan.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Biomedical Information Technology Lab, the University of Aizu, Tsuruga, Ikki-machi, Aizu-Wakamatsu, Fukushima, Japan.
authors.forename: Wenxi
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Seiryo-Machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Seiryo-Machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D018780:Body Surface Potential Mapping / Q000379:methods*; D003198:Computer Simulation; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000502:physiology*; D006801:Humans; D008955:Models, Cardiovascular; D016276:Ventricular Function / Q000502:physiology*
keywords: Action potential duration gradient; Computer simulation; Electrocardiogram; T wave; Whole-heart model