Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment
Background. 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 t...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2022/9125224 |
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| author | Maria Isabel Pons Jordi Mill Alvaro Fernandez-Quilez Andy L. Olivares Etelvino Silva Tom de Potter Oscar Camara |
| author_facet | Maria Isabel Pons Jordi Mill Alvaro Fernandez-Quilez Andy L. Olivares Etelvino Silva Tom de Potter Oscar Camara |
| author_sort | Maria Isabel Pons |
| collection | DOAJ |
| description | Background. 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. Objective. To demonstrate the need for combining left atrial morphological and haemodynamics indices to improve the thrombogenic risk assessment in nonvalvular AF patients. Methods. 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). Results. 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. Conclusion. 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. |
| format | Article |
| id | doaj-art-51e4be41a5544c3b8d9472f7593e279e |
| institution | Kabale University |
| issn | 1540-8183 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-51e4be41a5544c3b8d9472f7593e279e2025-02-03T05:58:10ZengWileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/9125224Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk AssessmentMaria Isabel Pons0Jordi Mill1Alvaro Fernandez-Quilez2Andy L. Olivares3Etelvino Silva4Tom de Potter5Oscar Camara6Department of Information and Communication TechnologiesDepartment of Information and Communication TechnologiesDepartment of RadiologyDepartment of Information and Communication TechnologiesInstitute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA)Department of CardiologyDepartment of Information and Communication TechnologiesBackground. 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. Objective. To demonstrate the need for combining left atrial morphological and haemodynamics indices to improve the thrombogenic risk assessment in nonvalvular AF patients. Methods. 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). Results. 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. Conclusion. 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.http://dx.doi.org/10.1155/2022/9125224 |
| spellingShingle | Maria Isabel Pons Jordi Mill Alvaro Fernandez-Quilez Andy L. Olivares Etelvino Silva Tom de Potter Oscar Camara Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment Journal of Interventional Cardiology |
| title | Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment |
| title_full | Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment |
| title_fullStr | Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment |
| title_full_unstemmed | Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment |
| title_short | Joint Analysis of Morphological Parameters and In Silico Haemodynamics of the Left Atrial Appendage for Thrombogenic Risk Assessment |
| title_sort | joint analysis of morphological parameters and in silico haemodynamics of the left atrial appendage for thrombogenic risk assessment |
| url | http://dx.doi.org/10.1155/2022/9125224 |
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