Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou, China.
Clin Radiol. 2024 Oct;79(10):e1243-e1251. doi: 10.1016/j.crad.2024.05.022. Epub 2024 Jun 29.
To investigate the relationship between left atrial appendage (LAA) morphology, quantified based on fractal dimension (FD), and LAA hemodynamic parameters in patients with atrial fibrillation (AF), in an effort to reveal the effect of LAA shape on blood flow.
225 patients with AF who underwent cardiac computed tomography angiography (CTA) and transesophageal echocardiography (TEE) were enrolled. LAA morphology was quantified based on FD on cardiac CTA images, and LAA hemodynamic parameters, including injection fraction (EF), filling peak flow velocity (FV), maximum speed of emptying (PEV), and wall motion velocity (WMV), were assessed using TEE.
We divided the patients with AF into two groups based on a mean LAA FD of 1.32: the low FD group (n=124) and the high FD group (n=101). Compared to the low FD group, there were more patients with LAA circulatory stasis/thrombus (P=0.008) in the high FD group, as well as lower LAA FV (P=0.004), LAA PEV (P=0.007), and LAA WMV (P=0.007). LAA FD was an independent and significant determinant of LAA EF (β = -11.755, P=0.001), LAA FV (β = -17.364, P=0.004), LAA PEV (β = -18.743, P<0.001), and LAA WMV (β = -7.740, P=0.001) in multiple linear regression analysis.
LAA FD is an essential determinant of LAA hemodynamic parameters, suggesting that the relatively complex morphology of the LAA may influence its hemodynamics, which can correlate with embolic events.
探讨基于分形维数（FD）量化的左心耳（LAA）形态与房颤（AF）患者 LAA 血流动力学参数之间的关系，以揭示 LAA 形态对血流的影响。
纳入 225 例接受心脏计算机断层血管造影（CTA）和经食管超声心动图（TEE）检查的 AF 患者。基于心脏 CTA 图像，FD 量化 LAA 形态，通过 TEE 评估 LAA 血流动力学参数，包括射血分数（EF）、充盈峰值流速（FV）、排空最大速度（PEV）和壁运动速度（WMV）。
我们根据平均 LAA FD 值（1.32）将 AF 患者分为两组：低 FD 组（n=124）和高 FD 组（n=101）。与低 FD 组相比，高 FD 组患者 LAA 循环停滞/血栓形成的比例更高（P=0.008），LAA FV（P=0.004）、LAA PEV（P=0.007）和 LAA WMV（P=0.007）均较低。多元线性回归分析显示，LAA FD 是 LAA EF（β=-11.755，P=0.001）、LAA FV（β=-17.364，P=0.004）、LAA PEV（β=-18.743，P<0.001）和 LAA WMV（β=-7.740，P=0.001）的独立且显著的决定因素。
LAA FD 是 LAA 血流动力学参数的重要决定因素，提示 LAA 相对复杂的形态可能影响其血流动力学，与栓塞事件相关。
