Annu Int Conf IEEE Eng Med Biol Soc. 2022 Jul;2022:3967-3971. doi: 10.1109/EMBC48229.2022.9871139.
In this paper, we present a computational fluid dynamic (CFD) model of left atrium (LA) to analyze the manifestation and progression of atrial fibrillation (AF) in terms of hemodynamic metrics. We propose a coupled lumped-CFD (0d-3d) pipeline to model and predict the pulsatile flow and pressure fields of three-dimensional cardiac chamber under the influence of sinus rhythm, high frequency AF (HF-AF) and LA remodeled AF, considering the interactions between the heart and the arterial system through a separately modeled 0d lumped hemodynamic cardiac model. A novel rhythm generator is modeled to generate modulated cardiac chamber compliance and decoupled auricular and ventricular contraction rate to synthesize variation in sinus rhythm and subsequent AF generation. CFD simulation were solved using subject specific CT scan. Systemic and pulmonary flow and pressure along with metrics related to wall shear stress in LA were derived. Left ventricular (LV) hemodynamic parameters associated with global cardio vascular evaluation like ejection fraction, stroke volume, cardiac output, etc. were also generated for all the rhythmic disturbance under consideration. The proposed 0d-3d coupled hemodynamic model of the LA can provide useful insights on the dynamics of AF manifestation and predict vulnerable regions in the cardiac chambers as well as arterial vasculature for probable thrombogenic plaque formation that leads to stroke and infraction, leading to heart failure.
在本文中，我们提出了一种左心房（LA）的计算流体动力学（CFD）模型，以分析血流动力学指标方面的房颤（AF）表现和进展。我们提出了一种耦合的集中式 CFD（0d-3d）管道，以在窦性节律、高频 AF（HF-AF）和 LA 重构 AF 的影响下对三维心脏腔室的脉动流和压力场进行建模和预测，通过单独建模的 0d 集中式血流动力学心脏模型考虑心脏和动脉系统之间的相互作用。我们建立了一种新颖的节律发生器，以生成调制的心脏腔室顺应性，并解耦心房和心室的收缩率，从而合成窦性节律和随后的 AF 生成的变化。使用特定于主体的 CT 扫描来解决 CFD 模拟。得出了与 LA 壁面切应力相关的全身和肺血流量和压力以及度量值。还为考虑的所有节律干扰生成了与整体心血管评估相关的左心室（LV）血流动力学参数，如射血分数、每搏输出量、心输出量等。LA 的这种 0d-3d 耦合的血流动力学模型可以提供有关 AF 表现动态的有用见解，并预测心脏腔室和动脉脉管系统中的脆弱区域，以便可能形成导致中风和梗塞的血栓形成斑块，从而导致心力衰竭。
