Summary results of work sensitivity analysis.

Sensitivity analysis involved replacing one patient-specific parameter from the model at a time to assess how the regional work metrics were influenced by the specificity of each parameter. Each column shows the patient-specific parameters included (shaded circles) in the model and the one parameter replaced with patient-averaged values (empty circle) in the model. The sensitivity of computed volume fractions of negative work in the LV (VfLVNW) and septum (VfSTNW) at baseline and change after CRT to model parameters was assessed by substituting the original patient-specific (Ps) parameters with patient-averaged parameters for the geometry (G), activation times (A), mechanics (M), and hemodynamics (H). In patients with myocardial infarction, the infarct was removed (I). Sensitivity of VfLVNW and VfSTNW to patient-specific parameters was measured via Pearson correlation (R2) to ΔESVLV and normalized root mean square deviation (nRMSD) from the Ps model. Patient-averaged hemodynamics and simultaneous geometry and electrical activation times (GA) eliminated the significant correlation between the outcome and the volume fraction of the LV performing negative work at LBBB. The significant correlation between ΔESVLV and ΔVfSTNW was eliminated using average geometry and electrical activation pattern during acute CRT.

本敏感性分析通过依次替换模型中的单一项患者特异性参数（patient-specific parameter），以评估各参数的特异性对区域功指标的影响程度。每一列分别展示模型中纳入的患者特异性参数（以填充圆圈表示），以及本次分析中被替换为患者平均取值的单一项参数（以空心圆圈表示）。本研究通过将原始患者特异性（Ps）参数替换为几何结构（G）、激活时间（A）、力学特性（M）与血流动力学（H）的患者平均参数，评估了基线状态与心脏再同步治疗（CRT）后计算得到的左心室（LV）负功体积分数（VfLVNW）及室间隔负功体积分数（VfSTNW）对模型参数的敏感性。针对合并心肌梗死的患者，我们移除了梗死区域（I）的对应参数。本研究通过皮尔逊相关系数（Pearson correlation，R²）、左心室收缩末期容积变化量（ΔESVLV）以及相较于Ps模型的归一化均方根偏差（normalized root mean square deviation，nRMSD），量化了VfLVNW与VfSTNW对患者特异性参数的敏感性。采用患者平均血流动力学参数，同时结合几何结构与电激活时间（GA）的校正方式，消除了左束支传导阻滞（left bundle branch block，LBBB）状态下结局指标与左心室负功体积分数之间的显著相关性。在急性心脏再同步治疗期间，采用平均几何结构与电激活模式的校正方式，消除了ΔESVLV与ΔVfSTNW之间的显著相关性。