Impact of left atrial wall motion assumptions in fluid simulations on proposed predictors of thrombus formation

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• dc.contributor.author Kjeldsberg, Henrik A.
• dc.contributor.author Albors, Carlos
• dc.contributor.author Mill, Jordi
• dc.contributor.author Viladés-Medel, David
• dc.contributor.author Camara, Oscar
• dc.contributor.author Sundnes, Joakim
• dc.contributor.author Valen-Sendstad, Kristian
• dc.date.accessioned 2025-06-10T06:51:59Z
• dc.date.available 2025-06-10T06:51:59Z
• dc.date.issued 2024
• dc.description.abstract Atrial fibrillation (AF) poses a significant risk of stroke due to thrombus formation, which primarily occurs in the left atrial appendage (LAA). Medical image-based computational fluid dynamics (CFD) simulations can provide valuable insight into patient-specific hemodynamics and could potentially enhance personalized assessment of thrombus risk. However, the importance of accurately representing the left atrial (LA) wall dynamics has not been fully resolved. In this study, we compared four modeling scenarios; rigid walls, a generic wall motion based on a reference motion, a semi-generic wall motion based on patient-specific motion, and patient-specific wall motion based on medical images. We considered a LA geometry acquired from 4D computed tomography during AF, systematically performed convergence tests to assess the numerical accuracy of our solution strategy, and quantified the differences between the four approaches. The results revealed that wall motion had no discernible impact on LA cavity hemodynamics, nor on the markers that indicate thrombus formation. However, the flow patterns within the LAA deviated significantly in the rigid model, indicating that the assumption of rigid walls may lead to errors in the estimated risk factors. In contrast, the generic, semi-generic, and patient-specific cases were qualitatively similar. The results highlight the crucial role of wall motion on hemodynamics and predictors of thrombus formation, and also demonstrate the potential of using a generic motion model as a surrogate for the more complex patient-specific motion. While the present study considered a single case, the employed CFD framework is entirely open-source and designed for adaptability, allowing for integration of additional models and generic motions.
• dc.description.sponsorship This research was funded, in whole or in part, by The Research Council of Norway through the PARIS project (311117) and by ERACoSysMed under grant agreement no. 643271. We also acknowledge funding by the SimCardioTest project (Digital transformation in Health and Care SC1-DTH-06-2020) under grant agreement no. 101016496. Simulations were performed on the Saga cluster, with resources provided by UNINETT Sigma2—the National Infrastructure for High Performance Computing and Data Storage in Norway, grant number nn9249k, and on the Oracle HPC Cluster stack through Oracle Cloud credits and related resources provided by Oracle for Research.
• dc.format.mimetype application/pdf
• dc.identifier.citation Kjeldsberg HA, Albors C, Mill J, Viladés Medel D, Camara O, Sundnes J, et al. Impact of left atrial wall motion assumptions in fluid simulations on proposed predictors of thrombus formation. Int J Numer Method Biomed Eng. 2024 Jun;40(6):e3825. DOI: 10.1002/cnm.3825
• dc.identifier.doi http://dx.doi.org/10.1002/cnm.3825
• dc.identifier.issn 2040-7939
• dc.identifier.uri http://hdl.handle.net/10230/70647
• dc.language.iso eng
• dc.publisher Wiley
• dc.relation.ispartof International Journal for Numerical Methods in Biomedical Engineering. 2024 Jun;40(6):e3825
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/643271
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/101016496
• dc.rights © 2024 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Atrial fibrillation
• dc.subject.keyword Boundary conditions
• dc.subject.keyword Computational fluid dynamics
• dc.subject.keyword Hemodynamics
• dc.subject.keyword Leftatrium
• dc.subject.keyword Moving domain
• dc.subject.keyword Thrombus formation
• dc.title Impact of left atrial wall motion assumptions in fluid simulations on proposed predictors of thrombus formation
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion