论文标题

心房颤动对左心动力学的影响:一项计算流体动力学研究

Impact of Atrial Fibrillation on Left Atrium Haemodynamics: A Computational Fluid Dynamics Study

论文作者

Corti, Mattia, Zingaro, Alberto, Dede', Luca, Quarteroni, Alfio Maria

论文摘要

我们分析了左心动力学,强调了受房颤影响的健康个体和患者的差异。计算研究基于左心房的患者特异性几何形状,以模拟血流动力学。我们设计了一种旨在恢复3D血液动力学模拟边界条件的新型程序,对于没有临床测量提供的特定特定方法,特别有用。以此目的,我们介绍了心房位移的参数定义,并采用了整个心脏循环系统的闭环总参数模型,可以根据患者特征进行调整。我们评估了心房血流动力学的许多流体动力学指标,从几种临床测量方面验证了我们的数值结果;我们研究了几何和临床特征对血栓形成风险的影响。为了分析血栓形成与房颤的相关性,与医学证据一致,我们提出了一个新的指标,我们称之为年龄暂停,这是由欧拉尔和拉格朗日数量的组合产生的。该指标确定了缓慢流无法正确冲洗腔室的区域,积累了陈旧的血液颗粒并为凝块形成创造最佳条件。

We analyze left atrium haemodynamics, highlighting differences among healthy individuals and patients affected by atrial fibrillation. The computational study is based on patient-specific geometries of the left atria to simulate blood flow dynamics. We devise a novel procedure aimed at recovering the boundary conditions for the 3D haemodynamics simulations, particularly useful in absence of specific ones provided by clinical measurements. With this aim, we introduce a parametric definition of the atria displacement, and we employ a closed-loop lumped parameter model of the whole cardiocirculatory system conveniently tuned on the basis of the patient characteristics. We evaluate a number of fluid dynamics indicators for the atrial haemodynamics, validating our numerical results in terms of several clinical measurements; we investigate the impact of geometrical and clinical features on the risk of thrombosis. To analyse the correlation of thrombus formation with atrial fibrillation, coherently with the medical evidence, we propose a novel indicator, which we call age stasis and that arises from the combination of Eulerian and Lagrangian quantities. This indicator identifies regions where the slow flow cannot rinse the chamber properly, accumulating stale blood particles and creating optimal conditions for clot formation.

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