| Sumario: | Anatomical changes associated with intra-uterine growth restriction (IUGR) have been observed in different age groups and linked to cardiovascular complications. This study analysed the electrocardiogram (ECG) in pre-adolescents with severe IUGR, comparing QRS complex and T-wave biomarkers with controls. Computer simulations explored links between anatomical re-modelling and ECG biomarkers, providing insights into the potential cardiovascular risk associated with IUGR-induced re-modelling. Clinical recordings were analysed using principal component analysis (PCA) to compute spatially transformed leads, enhancing QRS complex and T-wave delineation for depolarization and repolarization assessment. Transformed leads analysis revealed a 4-ms increase in QRS complex duration (QRS ) and a 2-ms increase in the T peak-to-end interval (T ) in IUGR subjects compared to controls. We conducted electrophysiological in silico simulations using anatomical models based on clinical IUGR data. These models, derived from a reference control, incorporated key geometric changes associated with IUGR, the apex-base length, basal diameter, wall thickness () and ventricular tissue volume, to assess their impact on depolarization and repolarization intervals. In silico PCA leads showed increased QRS , QRS amplitude and T in globular models, consistent with clinical data. Despite the QRS increase, the QT interval increases but is not linearly related to the change. These findings suggest that cardiac re-modelling primarily influences the depolarization cycle, notably QRS , while repolarization intervals increase but are not directly related to the increase. The study highlights the impact of geometric and volumetric changes in IUGR-related cardiac re-modelling, also emphasizing the need for further research on electrophysiological re-modelling and its effects on cardiac function.
|
|---|
