RT Journal Article
T1 Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment.
A1 Pons, Maria Isabel
A1 Mill, Jordi
A1 Fernandez-Quilez, Alvaro
A1 Olivares, Andy L
A1 Silva, Etelvino
A1 de Potter, Tom
A1 Camara, Oscar
K1 Atrial appendage
K1 Atrial fibrillation
K1 Blood flow velocity
AB Atrial fibrillation (AF) is considered the most common human arrhythmia. In nonvalvular AF, around 99% of thrombi are formed in the left atrial appendage (LAA). Nevertheless, there is not a consensus in the community about the relevant factors to stratify the AF population according to thrombogenic risk. To demonstrate the need for combining left atrial morphological and haemodynamics indices to improve the thrombogenic risk assessment in nonvalvular AF patients. A cohort of 71 nonvalvular AF patients was analysed. Statistical analysis, regression models, and random forests were used to analyse the differences between morphological and haemodynamics parameters, extracted from computational simulations built on 3D rotational angiography images, between patients with and without transient ischemic attack (TIA) or cerebrovascular accident (CVA). The analysis showed that models composed of both morphological and haemodynamic factors were better predictors of TIA/CVA compared with models based on either morphological or haemodynamic factors separately. Maximum ostium diameter, length of the centreline, blood flow velocity within the LAA, oscillatory shear index, and time average wall shear stress parameters were found to be key risk factors for TIA/CVA prediction. In addition, TIA/CVA patients presented more flow stagnation within the LAA. Thrombus formation in the LAA is the result of multiple factors. Analyses based only on morphological or haemodynamic parameters are not precise enough to predict such a phenomenon, as demonstrated in our results; a better patient stratification can be obtained by jointly analysing morphological and haemodynamic features.
PB Wiley
YR 2022
FD 2022-02-18
LK http://hdl.handle.net/10668/20180
UL http://hdl.handle.net/10668/20180
LA en
NO Pons MI, Mill J, Fernandez-Quilez A, Olivares AL, Silva E, de Potter T, et al.  Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment. J Interv Cardiol. 2022 Mar 14;2022:9125224
NO )is work was supported by the Spanish Ministry of Science, Innovation and Universities under the Retos I+D Programme (RTI2018-101193-B-I00), the Maria de Maeztu Units of Excellence Programme (MDM-2015-0502), theSpanish Ministry of Economy and Competitiveness under the Programme for the Formation of Doctors (PRE2018-084062), and MINECO (RYC-2015-18888).
DS RISalud
RD Apr 10, 2025