The role of the pulmonary veins on left atrial flow patterns and thrombus formation

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  • dc.contributor.author Mill, Jordi
  • dc.contributor.author Harrison, Josquin
  • dc.contributor.author Saiz-Vivó, Marta
  • dc.contributor.author Albors, Carlos
  • dc.contributor.author Morales, Xabier
  • dc.contributor.author Olivares, Andy L.
  • dc.contributor.author Iriart, Xavier
  • dc.contributor.author Cochet, Hubert
  • dc.contributor.author Noailly, Jérôme
  • dc.contributor.author Sermesant, Maxime
  • dc.contributor.author Camara, Oscar
  • dc.date.accessioned 2025-10-21T05:44:49Z
  • dc.date.available 2025-10-21T05:44:49Z
  • dc.date.issued 2024
  • dc.description.abstract Atrial fibrillation (AF) is the most common human arrhythmia, forming thrombi mostly in the left atrial appendage (LAA). However, the relation between LAA morphology, blood patterns and clot formation is not yet fully understood. Furthermore, the impact of anatomical structures like the pulmonary veins (PVs) have not been thoroughly studied due to data acquisition difficulties. In-silico studies with flow simulations provide a detailed analysis of blood flow patterns under different boundary conditions, but a limited number of cases have been reported in the literature. To address these gaps, we investigated the influence of PVs on LA blood flow patterns and thrombus formation risk through computational fluid dynamics simulations conducted on a sizeable cohort of 130 patients, establishing the largest cohort of patient-specific LA fluid simulations reported to date. The investigation encompassed an in-depth analysis of several parameters, including pulmonary vein orientation (e.g., angles) and configuration (e.g., number), LAA and LA volumes as well as their ratio, flow, and mass-less particles. Our findings highlight the total number of particles within the LAA as a key parameter for distinguishing between the thrombus and non-thrombus groups. Moreover, the angles between the different PVs play an important role to determine the flow going inside the LAA and consequently the risk of thrombus formation. The alignment between the LAA and the main direction of the left superior pulmonary vein, or the position of the right pulmonary vein when it exhibits greater inclination, had an impact to distinguish the control group vs. the thrombus group. These insights shed light on the intricate relationship between PV configuration, LAA morphology, and thrombus formation, underscoring the importance of comprehensive blood flow pattern analyses.en
  • dc.description.sponsorship This work was supported by the Spanish Ministry of Science, Innovation and Universities under the Retos I+D Programme (RTI2018-101193-B-I00) and GENERALITAAT (PID2022-143239OB-I00), the Maria de Maeztu Units of Excellence Programme (MDM-2015-0502), the Spanish Ministry of Economy and Competitiveness under the Programme for the Formation of Doctors (PRE2018-084062), and MINECO (RYC-2015-18888). Additionally, this work was supported by the H2020 EU SimCardioTest project (Digital transformation in Health and Care SC1-DTH-06-2020; grant agreement No. 101016496).en
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Mill J, Harrison J, Saiz-Vivo M, Albors C, Morales X, Olivares AL, et al. The role of the pulmonary veins on left atrial flow patterns and thrombus formation. Sci Rep. 2024 Mar 11;14(1):5860. DOI: 10.1038/s41598-024-56658-2
  • dc.identifier.doi http://dx.doi.org/10.1038/s41598-024-56658-2
  • dc.identifier.issn 2045-2322
  • dc.identifier.uri http://hdl.handle.net/10230/71594
  • dc.language.iso eng
  • dc.publisher Nature Research
  • dc.relation.ispartof Scientific Reports. 2024 Mar 11;14(1):5860
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/101016496
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/2PE/RTI2018-101193-B-I00
  • dc.rights This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.other Arrítmiaca
  • dc.subject.other Fibril·lació auricularca
  • dc.subject.other Cardiologiaca
  • dc.title The role of the pulmonary veins on left atrial flow patterns and thrombus formationen
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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