2026-04-13T02:53:17Zhttps://recercat.cat/oai/requestoai:recercat.cat:10230/465462025-12-23T20:54:42Zcom_2072_6col_2072_452954
RECERCAT
author
Pons Vidal, Maria Isabel
2021-02-19T11:36:41Z2021-02-19T11:36:41Z2020-07
Treball de fi de grau en BiomèdicaAtrial fibrillation (AF), which is considered the most common human arrhythmia, drastically
increases the risk of stroke. Around 99% of thrombi in non-valvular AF are formed in the
left atrial appendage (LAA). The current guidelines for patients stratification and treatment
depending on their thrombogenic risk is based on the CHA2DS2-VASc score that presents
some limitations since only a small subset of factors are considered. Furthermore, the role of
the LAA in the process of thrombus formation is not fully understood. Recent studies claimed
that morphological variables and haemodynamics indices could be better predictors than the
CHA2DS2-VASc score.
The aim of this project is to perform a joint analysis with haemodynamics indices extracted
from patient-specific simulations and morphological parameters of the left atrium (LA) and
LAA in order to improve the stratification of those patients who suffer from AF and better
tailor the treatment.
A cohort of 71 non-valvular AF patients, provided by OLV Hospital, was analyzed. Geometries
were obtained from 3D rotational angiography images and segmented. Computational fluid
dynamics (CFD) of 38 geometries were carried out. Haemodynamics indices related with the
risk of thrombus formation have been computed from CFD simulations such as endothelial
cell activation potential (ECAP) or relative residence time (RRT), together with velocity and
vorticity analysis. Moreover, morphologic and volumetric parameters, such as the length of the
centreline, the maximum ostium diameter and the bending angle of the LAA, have been gather
and analyzed.
A statistical analysis was performed to analyse the differences between morphological and
haemodynamics parameters between patients with and without transient ischemic attack (TIA)
history. The results of the statistical tests and regression models of morphological parameters
suggest that larger LAAs (e.g. larger ostium diameter), have a higher risk of thrombus formation.
As for haemodynamics parameters, none of them could accurately identify TIA vs
non-TIA patients. However, the Akaike information criterion (AIC) when combining morphological
and haemodynamics parameters in a regression model reported a good predictor model
for risk of thrombus formation was obtained.
Atribución-NoComercial-SinDerivadas 3.0 España http://creativecommons.org/licenses/by-nc-nd/3.0/es/ info:eu-repo/semantics/openAccess
Left atrial appendage
Computational fluid dynamics
Cardiac morphology
Atrial fibrillation
Thrombus formation
Joint analysis of in-silico haemodynamics and morphological parameters of the left atrial appendage
info:eu-repo/semantics/bachelorThesis