PDF(Pubmed)
Abstract：
UNASSIGNED: Atrial fibrillation (AF) is associated with an increased risk of stroke, often caused by thrombi that form in the left atrium (LA), and especially in the left atrial appendage (LAA). The underlying mechanism is not fully understood but is thought to be related to stagnant blood flow, which might be present despite sinus rhythm. However, measuring blood flow and stasis in the LAA is challenging due to its small size and low velocities. We aimed to compare the blood flow and stasis in the left atrium of paroxysmal AF patients with controls using computational fluid dynamics (CFD) simulations.
UNASSIGNED: The CFD simulations were based on time-resolved computed tomography including the patient-specific cardiac motion. The pipeline allowed for analysis of 21 patients with paroxysmal AF and 8 controls. Stasis was estimated by computing the blood residence time.
UNASSIGNED: Residence time was elevated in the AF group (p < 0.001). Linear regression analysis revealed that stasis was strongest associated with LA ejection ratio (p < 0.001, R2 = 0.68) and the ratio of LA volume and left ventricular stroke volume (p < 0.001, R2 = 0.81). Stroke risk due to LA thrombi could already be elevated in AF patients during sinus rhythm. In the future, patient specific CFD simulations may add to the assessment of this risk and support diagnosis and treatment.
UNASSIGNED: The CFD simulations were based on time-resolved computed tomography including the patient-specific cardiac motion. The pipeline allowed for analysis of 21 patients with paroxysmal AF and 8 controls. Stasis was estimated by computing the blood residence time.
UNASSIGNED: Residence time was elevated in the AF group (p < 0.001). Linear regression analysis revealed that stasis was strongest associated with LA ejection ratio (p < 0.001, R2 = 0.68) and the ratio of LA volume and left ventricular stroke volume (p < 0.001, R2 = 0.81). Stroke risk due to LA thrombi could already be elevated in AF patients during sinus rhythm. In the future, patient specific CFD simulations may add to the assessment of this risk and support diagnosis and treatment.
摘要：
■心房颤动(AF)与卒中风险增加相关,通常由左心房（LA）中形成的血栓引起，尤其是左心耳（LAA）。潜在的机制尚未完全了解，但被认为与停滞的血流有关，尽管存在窦性心律。然而,测量血液流动和停滞在左心耳是具有挑战性的，由于它的小尺寸和低速度。我们旨在使用计算流体动力学（CFD）模拟比较阵发性房颤患者与对照组的左心房血流和淤滞。
■CFD模拟基于时间分辨计算机断层扫描，包括患者特定的心脏运动。该管道允许分析21例阵发性房颤患者和8例对照。通过计算血液停留时间来估计停滞。
■在AF组中停留时间延长(p<0.001)。线性回归分析显示，血瘀与LA射血比（p<0.001，R2=0.68）以及LA体积与左心室每搏输出量之比（p<0.001，R2=0.81）密切相关。在窦性心律期间，房颤患者由于LA血栓引起的中风风险已经升高。在未来,患者特异性CFD模拟可能会增加对该风险的评估,并支持诊断和治疗.
■CFD模拟基于时间分辨计算机断层扫描，包括患者特定的心脏运动。该管道允许分析21例阵发性房颤患者和8例对照。通过计算血液停留时间来估计停滞。
■在AF组中停留时间延长(p<0.001)。线性回归分析显示，血瘀与LA射血比（p<0.001，R2=0.68）以及LA体积与左心室每搏输出量之比（p<0.001，R2=0.81）密切相关。在窦性心律期间，房颤患者由于LA血栓引起的中风风险已经升高。在未来,患者特异性CFD模拟可能会增加对该风险的评估,并支持诊断和治疗.
