The effects of hypocalcemia on spatial alternans and ventricular fibrillation studied with the optical mapping technique

The heart is a wonderful but complex organ: it uses electrochemical mechanisms in order to produce mechanical energy to pump the blood throughout the body and allow the life of humans and animals. This organ can be subject to several diseases and sudden cardiac death (SCD) is the most catastrophic manifestation of these diseases, responsible for the death of a large number of people throughout the world. It is estimated that 325000 Americans annually die for SCD. SCD most commonly occurs as a result of reentrant tachyarrhythmias (ventricular tachycardia (VT) and ventricular fibrillation (VF)) and the identification of those patients at higher risk for the development of SCD has been a difficult clinical challenge. Nowadays, a particular electrocardiogram (ECG) abnormality, “T-wave alternans” (TWA), is considered a precursor of lethal cardiac arrhythmias and sudden death, a sensitive indicator of risk for SCD. TWA is defined as a beat-to-beat alternation in the shape, amplitude, or timing of the T-wave on the ECG, indicative of the underlying repolarization of cardiac cells [5]. In other words TWA is the macroscopic effect of subcellular and celluar mechanisms involving ionic kinetics and the consequent depolarization and repolarization of the myocytes. Experimental activities have shown that TWA on the ECG is a manifestation of an underlying alternation of long and short action potential durations (APDs), the so called APD-alternans, of cardiac myocytes in the myocardium. Understanding the mechanism of APDs-alternans is the first step for preventing them to occur. In order to investigate these mechanisms it’s very important to understand that the biological systems are complex systems and their macroscopic properties arise from the nonlinear interactions among the parts. The whole is greater than the sum of the parts, and it cannot be understood only by studying the single parts. In this sense the heart is a complex nonlinear system and its way of working follows nonlinear dynamics; alternans also, they are a manifestation of a phenomenon typical in nonlinear dynamical systems, called “period-dubling bifurcation”. Over the past decade, it has been demonstrated that electrical alternans in cardiac tissue is an important marker for the development of ventricular fibrillation and a significant predictor for mortality. It has been observed that acute exposure to low concentration of calcium does not decrease the magnitude of alternans and sustained ventricular Fibrillation (VF) is still easily induced under these condition. However with prolonged exposure to low concentration of calcium, alternans disappears, but VF is still inducible. This work is based on this observation and tries to make it clearer. The aim of this thesis is investigate the effect of hypocalcemia spatial alternans and VF doing experiments with canine hearts and perfusing them with a solution with physiological ionic concentration and with a solution with low calcium concentration (hypocalcemia); in order to investigate the so called memory effect, the experimental activity was modified during the way. The experiments were performed with the optical mapping technique, using voltage-sensitive dye, and a custom made Java code was used in post-processing. Finding the Nolasco and Dahlen’s criterion [8] inadequate for the prediction of alternans, and takin into account the experimental results, another criterion, which consider the memory effect, has been implemented. The implementation of this criterion could be the first step in the creation of a method, AP-based, discriminating who is at risk if developing VF. This work is divided into four chapters: the first is a brief presentation of the physiology of the heart; the second is a review of the major theories and discovers in the study of cardiac dynamics; the third chapter presents an overview on the experimental activity and the optical mapping technique; the forth chapter contains the presentation of the results and the conclusions.

Private sensors and crowdsourced rainfall data: accuracy and effectiveness for monitoring severe events and mapping pluvial flooding in urban areas

The increasing number of extreme rainfall events, combined with the high population density and the imperviousness of the land surface, makes urban areas particularly vulnerable to pluvial flooding. In order to design and manage cities to be able to deal with this issue, the reconstruction of weather phenomena is essential. Among the most interesting data sources which show great potential are the observational networks of private sensors managed by citizens (crowdsourcing). The number of these personal weather stations is consistently increasing, and the spatial distribution roughly follows population density. Precisely for this reason, they perfectly suit this detailed study on the modelling of pluvial flood in urban environments. The uncertainty associated with these measurements of precipitation is still a matter of research. In order to characterise the accuracy and precision of the crowdsourced data, we carried out exploratory data analyses. A comparison between Netatmo hourly precipitation amounts and observations of the same quantity from weather stations managed by national weather services is presented. The crowdsourced stations have very good skills in rain detection but tend to underestimate the reference value. In detail, the accuracy and precision of crowd- sourced data change as precipitation increases, improving the spread going to the extreme values. Then, the ability of this kind of observation to improve the prediction of pluvial flooding is tested. To this aim, the simplified raster-based inundation model incorporated in the Saferplaces web platform is used for simulating pluvial flooding. Different precipitation fields have been produced and tested as input in the model. Two different case studies are analysed over the most densely populated Norwegian city: Oslo. The crowdsourced weather station observations, bias-corrected (i.e. increased by 25%), showed very good skills in detecting flooded areas.