Patient-specific pulmonary venous flow characterization and its impact on left atrial appendage thrombosis in atrial fibrillation patients

IF 4.9 2区 医学 Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Computer methods and programs in biomedicine Pub Date : 2024-09-17 DOI:10.1016/j.cmpb.2024.108428
Runxin Fang , Zidun Wang , Jiaqiu Wang , Jiayu Gu , Geman Yin , Qiang Chen , Xunrong Xia , Zhiyong Li
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Abstract

Background

Cardioembolic strokes are commonly occurred in non-valvular atrial fibrillation (AF) patients, with over 90% of cases originating from clot in left atrial appendage (LAA), which is believed to be greatly related with hemodynamic characters. Numerical simulation is widely accepted in the hemodynamic analysis, and patient-specific boundaries are required for realistic numerical simulations.

Method

This paper firstly proposed a method that maps personalized pulmonary venous flow (PVF) by utilizing the volume changes of the left atrium (LA) over the cardiac cycle. Then we used data from patients with AF to investigate the correlation between PVF patterns and hemodynamics within the LAA. Meanwhile, we conducted a fluid-structure interaction analysis to assess the impact of velocity- and time-related PVF parameters on LAA hemodynamic characters.

Results

The analysis reveal that the ratio of systolic to diastolic peak velocity (VS/VD), and systolic velocity-time integral (VTI) showed a significant influence on LAA velocity in patients with atrial fibrillation, and the increases of velocity- and time-related parameters were found to be positively correlated with the blood update in the LAA.

Conclusions

This study established a method for mapping patient-specific PVF based on LA volume change, and evaluated the relationship between PVF parameters and thrombosis risk. The present work provides an insight from PVF characters to evaluate the risk of thrombus formation within LAA in patients with AF.
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心房颤动患者肺静脉血流特征及其对左心房阑尾血栓形成的影响
背景心血管栓塞性脑卒中常见于非瓣膜性心房颤动(房颤)患者,其中90%以上的病例源于左心房附壁(LAA)的血栓,这被认为与血流动力学特征有很大关系。本文首先提出了一种利用左心房(LA)在心动周期中的容积变化绘制个性化肺静脉流量(PVF)的方法。然后,我们利用房颤患者的数据研究了 PVF 模式与 LAA 内血流动力学之间的相关性。结果分析表明,收缩期与舒张期峰值速度之比(VS/VD)和收缩期速度-时间积分(VTI)对心房颤动患者的 LAA 速度有显著影响,速度和时间相关参数的增加与 LAA 的血液更新呈正相关。结论本研究建立了一种基于 LA 容积变化绘制患者特异性 PVF 的方法,并评估了 PVF 参数与血栓形成风险之间的关系。本研究提供了从 PVF 字符评估房颤患者 LAA 内血栓形成风险的见解。
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来源期刊
Computer methods and programs in biomedicine
Computer methods and programs in biomedicine 工程技术-工程:生物医学
CiteScore
12.30
自引率
6.60%
发文量
601
审稿时长
135 days
期刊介绍: To encourage the development of formal computing methods, and their application in biomedical research and medical practice, by illustration of fundamental principles in biomedical informatics research; to stimulate basic research into application software design; to report the state of research of biomedical information processing projects; to report new computer methodologies applied in biomedical areas; the eventual distribution of demonstrable software to avoid duplication of effort; to provide a forum for discussion and improvement of existing software; to optimize contact between national organizations and regional user groups by promoting an international exchange of information on formal methods, standards and software in biomedicine. Computer Methods and Programs in Biomedicine covers computing methodology and software systems derived from computing science for implementation in all aspects of biomedical research and medical practice. It is designed to serve: biochemists; biologists; geneticists; immunologists; neuroscientists; pharmacologists; toxicologists; clinicians; epidemiologists; psychiatrists; psychologists; cardiologists; chemists; (radio)physicists; computer scientists; programmers and systems analysts; biomedical, clinical, electrical and other engineers; teachers of medical informatics and users of educational software.
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