School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Biomech Model Mechanobiol. 2021 Aug;20(4):1431-1443. doi: 10.1007/s10237-021-01454-4. Epub 2021 Mar 23.
Most strokes in patients with atrial fibrillation (AF) are thought to arise from thrombus formation in the left atrial appendage (LAA). Assessing the hemodynamics in LAA and left atrium (LA) may provide some insights in the evaluation of the risk of thrombus formation. This study aims to find out the impact of different LAA locations with respect of LA on the risk of thrombus formation within LAA in patients with AF. Three different LAA locations at LA were modeled and a fully coupled fluid-structure interaction analysis was performed. A discrete phase method was used for particle residence analysis to evaluate risk of the thrombus formation. The results showed that LAA positions on the LA affected the LAA flow velocity distribution, passive contraction ability, and particle residence. In particular, the left pulmonary veins (PVs) had a greater influence on the LAA hemodynamics than the right PVs. The LAA had the lowest contractibility when it was located between left superior and left inferior PVs, and in this case, a larger number of particles were resided, which indicated a higher risk of thrombus formation. The present work provides a quantitative way to evaluate the risk of thrombus formation within LAA in patients with AF.
大多数房颤（AF）患者的中风被认为是由于左心耳（LAA）内血栓形成引起的。评估 LAA 和左心房（LA）的血流动力学可能为血栓形成风险的评估提供一些见解。本研究旨在探讨不同的 LAA 相对于 LA 的位置对 AF 患者 LAA 内血栓形成风险的影响。模拟了 LA 中的三个不同的 LAA 位置，并进行了完全耦合的流固耦合分析。使用离散相方法进行颗粒停留分析，以评估血栓形成的风险。结果表明，LA 上的 LAA 位置影响 LAA 的流速分布、被动收缩能力和颗粒停留。特别是，左肺静脉（PVs）对 LAA 血流动力学的影响大于右 PVs。当 LAA 位于左上和左下肺静脉之间时，其收缩性最低，此时停留的颗粒数量较多，表明血栓形成的风险较高。本工作提供了一种定量评估 AF 患者 LAA 内血栓形成风险的方法。
