Elevated atrial blood stasis in paroxysmal atrial fibrillation during sinus rhythm: a patient-specific computational fluid dynamics study

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Bäck, SophiaLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV (author)

Elevated atrial blood stasis in paroxysmal atrial fibrillation during sinus rhythm: a patient-specific computational fluid dynamics study

Article/chapterEnglish2023

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FRONTIERS MEDIA SA,2023
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:liu-197884
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-197884URI
https://doi.org/10.3389/fcvm.2023.1219021DOI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies|This project was funded by the Swedish Medical Research Council (2018-02779); the Swedish research council (2018-04454), ALF Grants, Region Ouml;stergouml;tland (974839 and 969563); Swedish Heart and Lung Foundation (20200220 and 20210441), VINNOVA (2019 [2018-04454]; Swedish Medical Research Council [974839]; Swedish research council [969563, 20200220]; ALF Grants [20210441, 2019-02261]; Swedish Heart and Lung Foundation [2021/3-35]; VINNOVA; Henry och Ella Sthls foundation; Swedish National Infrastructure for Computing (SNIC) - Swedish Research Council; [2018-02779]
Introduction: 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.Methods : 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.Results and Discussion: 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, R-2 = 0.68) and the ratio of LA volume and left ventricular stroke volume (p < 0.001, R-2 = 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.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
atrial fibrillation; computational fluid dynamics; left atrial appendage; computed tomography; atrial cardiomyopathy; stroke

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Skoda, IuliaLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)iulsk88 (author)
Lantz, JonasLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV(Swepub:liu)jonla63 (author)
Henriksson, LilianLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)lilhe58 (author)
Karlsson, LarsLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)larka64 (author)
Persson, AndersLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Röntgenkliniken i Linköping(Swepub:liu)andpe75 (author)
Carlhäll, CarljohanLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Fysiologiska kliniken US(Swepub:liu)carca13 (author)
Ebbers, TinoLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV(Swepub:liu)tineb49 (author)
Linköpings universitetAvdelningen för diagnostik och specialistmedicin (creator_code:org_t)

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