Impact of left atrial appendage location on risk of thrombus formation in patients with atrial fibrillation
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 th...
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| Published in | Biomechanics and modeling in mechanobiology Vol. 20; no. 4; pp. 1431 - 1443 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.08.2021
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1617-7959 1617-7940 1617-7940 |
| DOI | 10.1007/s10237-021-01454-4 |
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| Abstract | 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. |
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| AbstractList | 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. 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.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. |
| Author | Liu, Quanjun Zhang, Yanjuan Li, Yang Fang, Runxin Chen, Qiang Li, Zhiyong |
| Author_xml | – sequence: 1 givenname: Runxin surname: Fang fullname: Fang, Runxin organization: School of Biological Science and Medical Engineering, Southeast University – sequence: 2 givenname: Yang surname: Li fullname: Li, Yang organization: Zhongda Hospital, Southeast University – sequence: 3 givenname: Yanjuan surname: Zhang fullname: Zhang, Yanjuan organization: First Affiliated Hospital, Nanjing Medical University – sequence: 4 givenname: Qiang surname: Chen fullname: Chen, Qiang organization: School of Biological Science and Medical Engineering, Southeast University – sequence: 5 givenname: Quanjun surname: Liu fullname: Liu, Quanjun email: lqj@seu.edu.cn organization: School of Biological Science and Medical Engineering, Southeast University – sequence: 6 givenname: Zhiyong orcidid: 0000-0002-6814-9165 surname: Li fullname: Li, Zhiyong email: zylicam@gmail.com organization: School of Biological Science and Medical Engineering, Southeast University, School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT) |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33755847$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021. |
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| Keywords | Thrombus formation Fluid–structure interaction Left atrial appendage Hemodynamics Atrial fibrillation |
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| Snippet | Most strokes in patients with atrial fibrillation (AF) are thought to arise from thrombus formation in the left atrial appendage (LAA). Assessing the... |
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| SubjectTerms | Atria Atrial Appendage - physiopathology Atrial Fibrillation - physiopathology Biological and Medical Physics Biomechanical Phenomena Biomedical Engineering and Bioengineering Biophysics Blood clots Blood Flow Velocity Cardiac arrhythmia Contraction Engineering Evaluation Fibrillation Flow velocity Fluid-structure interaction Hemodynamics Humans Models, Cardiovascular Original Paper Risk Risk assessment Silicones Stroke - physiopathology Theoretical and Applied Mechanics Thrombosis Thrombosis - physiopathology Velocity distribution |
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| Title | Impact of left atrial appendage location on risk of thrombus formation in patients with atrial fibrillation |
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