流动动力学因素与与装置相关的血栓形成有关,在左心房附属体闭塞后
Brennan J Vogl1, Emily Vitale1, Sunyoung Ahn1
1Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan, USA.
JACC. Advances
|November 4, 2024
概括
在左心房附带闭塞 (LAAO) 之后,与设备相关的血栓形成 (DRT) 是一个风险. 较低的墙壁切削应力和较高的振荡切削指数预测DRT,这表明流动动力学可以指导风险分层.
科学领域:
- 心血管医学 心血管医学
- 生物医学工程 生物医学工程
- 医疗成像医学成像
背景情况:
- 与设备相关的血栓形成 (DRT) 复杂化了高达4%的左心房尾闭塞 (LAAO) 程序.
- 对DRT的确切原因,预测因素和最佳治疗方法尚不清楚,需要进一步研究.
研究的目的:
- 调查血液动力学因素与LAAO后DRT的发生之间的相关性.
- 确定特定的流动动力学,可以预测在接受LAAO的患者中DRT风险.
主要方法:
- 利用了接受LAAO的患者的多中心注册表,并进行了手术前和后的CT成像.
- 为有限元和计算流体动力学 (CFD) 模拟创建了患者特定的左心室3D模型.
- 量化血液动力学参数:时间平均的壁切应力,振荡切指数和内皮细胞激活潜力.
主要成果:
- 将19名DRT患者与19名没有DRT患者进行比较,在DRT组中发现左心室体积和中心区域较大.
- 接受DRT的患者表现出明显较低的时间平均壁切应力和较高的振荡切索指数和内皮细胞激活潜力 (P < 0.001).
- 活体中血栓的位置与CFD衍生的流动动态参数有很好的相关性.
结论:
- 来自CFD模拟的血液动力学参数显示,在LAAO后预测DRT风险具有潜力.
- 需要进行更多的长期随访的大规模研究,以验证CFD在LAAO患者风险分层中的作用.
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