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Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation
Atrial fibrillation (AF) is the most common arrhythmia that leads to thrombus formation, mostly in the left atrial appendage (LAA). The current standard of stratifying stroke risk, based on the CHA(2)DS(2)-VASc score, does not consider LAA morphology, and the clinically accepted LAA morphology-based...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148016/ https://www.ncbi.nlm.nih.gov/pubmed/34045972 http://dx.doi.org/10.3389/fphys.2021.633135 |
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author | Sanatkhani, Soroosh Nedios, Sotirios Menon, Prahlad G. Bollmann, Andreas Hindricks, Gerhard Shroff, Sanjeev G. |
author_facet | Sanatkhani, Soroosh Nedios, Sotirios Menon, Prahlad G. Bollmann, Andreas Hindricks, Gerhard Shroff, Sanjeev G. |
author_sort | Sanatkhani, Soroosh |
collection | PubMed |
description | Atrial fibrillation (AF) is the most common arrhythmia that leads to thrombus formation, mostly in the left atrial appendage (LAA). The current standard of stratifying stroke risk, based on the CHA(2)DS(2)-VASc score, does not consider LAA morphology, and the clinically accepted LAA morphology-based classification is highly subjective. The aim of this study was to determine whether LAA blood-borne particle residence time distribution and the proposed quantitative index of LAA 3D geometry can add independent information to the CHA(2)DS(2)-VASc score. Data were collected from 16 AF subjects. Subject-specific measurements included left atrial (LA) and LAA 3D geometry obtained by cardiac computed tomography, cardiac output, and heart rate. We quantified 3D LAA appearance in terms of a novel LAA appearance complexity index (LAA-ACI). We employed computational fluid dynamics analysis and a systems-based approach to quantify residence time distribution and associated calculated variable (LAA mean residence time, t(m)) in each subject. The LAA-ACI captured the subject-specific LAA 3D geometry in terms of a single number. LAA t(m) varied significantly within a given LAA morphology as defined by the current subjective method and it was not simply a reflection of LAA geometry/appearance. In addition, LAA-ACI and LAA t(m) varied significantly for a given CHA(2)DS(2)-VASc score, indicating that these two indices of stasis are not simply a reflection of the subjects' clinical status. We conclude that LAA-ACI and LAA t(m) add independent information to the CHA(2)DS(2)-VASc score about stasis risk and thereby can potentially enhance its ability to stratify stroke risk in AF patients. |
format | Online Article Text |
id | pubmed-8148016 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-81480162021-05-26 Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation Sanatkhani, Soroosh Nedios, Sotirios Menon, Prahlad G. Bollmann, Andreas Hindricks, Gerhard Shroff, Sanjeev G. Front Physiol Physiology Atrial fibrillation (AF) is the most common arrhythmia that leads to thrombus formation, mostly in the left atrial appendage (LAA). The current standard of stratifying stroke risk, based on the CHA(2)DS(2)-VASc score, does not consider LAA morphology, and the clinically accepted LAA morphology-based classification is highly subjective. The aim of this study was to determine whether LAA blood-borne particle residence time distribution and the proposed quantitative index of LAA 3D geometry can add independent information to the CHA(2)DS(2)-VASc score. Data were collected from 16 AF subjects. Subject-specific measurements included left atrial (LA) and LAA 3D geometry obtained by cardiac computed tomography, cardiac output, and heart rate. We quantified 3D LAA appearance in terms of a novel LAA appearance complexity index (LAA-ACI). We employed computational fluid dynamics analysis and a systems-based approach to quantify residence time distribution and associated calculated variable (LAA mean residence time, t(m)) in each subject. The LAA-ACI captured the subject-specific LAA 3D geometry in terms of a single number. LAA t(m) varied significantly within a given LAA morphology as defined by the current subjective method and it was not simply a reflection of LAA geometry/appearance. In addition, LAA-ACI and LAA t(m) varied significantly for a given CHA(2)DS(2)-VASc score, indicating that these two indices of stasis are not simply a reflection of the subjects' clinical status. We conclude that LAA-ACI and LAA t(m) add independent information to the CHA(2)DS(2)-VASc score about stasis risk and thereby can potentially enhance its ability to stratify stroke risk in AF patients. Frontiers Media S.A. 2021-05-11 /pmc/articles/PMC8148016/ /pubmed/34045972 http://dx.doi.org/10.3389/fphys.2021.633135 Text en Copyright © 2021 Sanatkhani, Nedios, Menon, Bollmann, Hindricks and Shroff. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Physiology Sanatkhani, Soroosh Nedios, Sotirios Menon, Prahlad G. Bollmann, Andreas Hindricks, Gerhard Shroff, Sanjeev G. Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title | Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title_full | Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title_fullStr | Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title_full_unstemmed | Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title_short | Subject-Specific Calculation of Left Atrial Appendage Blood-Borne Particle Residence Time Distribution in Atrial Fibrillation |
title_sort | subject-specific calculation of left atrial appendage blood-borne particle residence time distribution in atrial fibrillation |
topic | Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148016/ https://www.ncbi.nlm.nih.gov/pubmed/34045972 http://dx.doi.org/10.3389/fphys.2021.633135 |
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