Comprehensive Left Atrial Flow Component Analysis Reveals Abnormal Flow Patterns in Paroxysmal Atrial Fibrillation

Am J Physiol Heart Circ Physiol. 2023 Dec 22. doi: 10.1152/ajpheart.00614.2023. Online ahead of print.ABSTRACTLeft atrial (LA) blood flow plays an important role in diseases such as atrial fibrillation (AF) and atrial cardiomyopathy since alterations in the blood flow might lead to thrombus formation and stroke. Using traditional techniques such as echocardiography, atrial flow velocities can be measured at the pulmonary veins and the mitral valve, but a comprehensive understanding of the three-dimensional atrial flow field is missing. Previously, ventricular flow has been analyzed using flow component analysis, revealing new insights into ventricular flow and function. Thus, the aim of this project was to develop a comprehensive flow component analysis method for the LA and explore its utility in 21 patients with paroxysmal atrial fibrillation, compared to a control group of 8 participants. The flow field was derived from time resolved CT acquired during sinus rhythm using computational fluid dynamics. Flow components were computed from particle tracking. We identified 6 atrial flow components: conduit, reservoir, delayed ejection, retained inflow, residual volume, and pulmonary vein backflow. It was shown that conduit flow, defined as blood entering and leaving the LA within the same diastolic phase, exists in most subjects. While the volume of conduit and reservoir is similar in patients with paroxysmal AF in sinus rhythm and controls, the volume of the other components is...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Source Type: research