Implications of IUGR-Related Geometric Heart Changes on the ECG and Electrophysiology: an In Silico Perspective

This study aimed to simulate the geometric changes resulting from intrauterine growth restriction (IUGR) in a realistic biventricular heart model and assess their impact on cardiac electrophysiology. Geometric alterations were based on echocardiography measurements from IUGR patients. The model exhibited a reduction in left ventricle sphericity index and an increase in left ventricular wall thickness. Results showed a significant prolongation of the QRS complex duration and an increase in R-wave magnitude when compared to control geometry, consistent with clinical findings. However, a modest increase in the T_pe interval, which aligns with clinical observations, is observed, while the QT interval shows a prolongation that contradicts clinical results. These findings suggest that while the simulated geometric changes reproduce certain clinical observations, others are not reproduced suggesting additional factors, such as changes in electrical activation and/or ionic remodeling influencing cardiac electrophysiology in IUGR, to be tested in future investigations.