Rodríguez-Aparicio Sergio, Ferrera Conrado, Fuentes-Cañamero María Eugenia, García García Javier, Dueñas-Pamplona Jorge
Departamento de Ingeniería Mecánica, Energética y de los Materiales, Universidad de Extremadura, Avda.de Elvas s/n, Badajoz, 06006, Spain.
Departamento de Ingeniería Mecánica, Energética y de los Materiales, Universidad de Extremadura, Avda.de Elvas s/n, Badajoz, 06006, Spain; Instituto de Computación Científica Avanzada (ICCAEX), Avda.de Elvas s/n, Badajoz, 06006, Spain.
Comput Biol Med. 2025 Mar;186:109612. doi: 10.1016/j.compbiomed.2024.109612. Epub 2025 Jan 7.
Despite the significant advances made in the field of computational fluid dynamics (CFD) to simulate the left atrium (LA) in atrial fibrillation (AF) conditions, the connection between atrial structure, flow dynamics, and blood stagnation in the left atrial appendage (LAA) remains unclear. Deepening our understanding of this relationship would have important clinical implications, as the thrombi formed within the LAA are one of the main causes of stroke.
To highlight and better understand the fundamental role of the PV orientation in forming atrial flow patterns and systematically quantifying its effect on blood stasis within the LAA.
Two patients with opposite atrial flow patterns were selected for the study. The atria were segmented and subsequently morphed to modify the pulmonary vein (PV) orientations in a highly controlled manner. CFD analysis were performed using a kinematic model able to reproduce AF conditions. Results were projected into the universal left atrial appendage coordinate (ULAAC) system to enhance data visualization and comparison.
The position of the main atrial vortex can be modified by controlled changes in the PV orientations, which to the best of our knowledge was not demonstrated before. This finding may have important clinical implications, as the behavior and position of the main atrial vortex is crucial to define the LA flow patterns and thus the LAA washing, making possible to assess the stroke risk for a particular patient.
尽管在计算流体动力学（CFD）领域取得了显著进展，能够在心房颤动（AF）条件下模拟左心房（LA），但心房结构、血流动力学与左心耳（LAA）内血液淤滞之间的联系仍不明确。加深我们对这种关系的理解将具有重要的临床意义，因为LAA内形成的血栓是中风的主要原因之一。
强调并更好地理解肺静脉（PV）方向在形成心房血流模式中的基本作用，并系统地量化其对LAA内血液淤滞的影响。
选择两名具有相反心房血流模式的患者进行研究。对心房进行分割，随后进行变形，以高度可控的方式改变肺静脉（PV）方向。使用能够再现AF条件的运动学模型进行CFD分析。将结果投影到通用左心耳坐标（ULAAC）系统中，以增强数据可视化和比较。
据我们所知，通过对PV方向进行可控改变，可以改变主要心房涡流的位置，这一点以前尚未得到证实。这一发现可能具有重要的临床意义，因为主要心房涡流的行为和位置对于定义LA血流模式以及LAA冲洗至关重要，从而有可能评估特定患者的中风风险。
