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 CHA2DS2-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 CHA2DS2-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, tm) in each subject. The LAA-ACI captured the subject-specific LAA 3D
geometry in terms of a single number. LAA tm varied significantly within a given LAA
morphology as defined by the current subjectivemethod and it was not simply a reflection
of LAA geometry/appearance. In addition, LAA-ACI and LAA tm varied significantly for a
given CHA2DS2-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 tm add
independent information to the CHA2DS2-VASc score about stasis risk and thereby can
potentially enhance its ability to stratify stroke risk in AF patients.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84421 |
| Date | 30 March 2023 |
| Creators | Sanatkhani, Soroosh, Nedios, Sotirios, Menon, Prahlad G., Bollmann, Andreas, Hindricks, Gerhard, Shroff, Sanjeev G. |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1664-042X, 633135 |
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