Shape analysis and computational fluid simulations to assess feline left atrial function and thrombogenesis

Abstract

In humans, there is a well-established relationship between atrial fibrillation (AF), blood flow abnormalities and thrombus formation, even if there is no clear consensus on the role of left atrial appendage (LAA) morphologies. Cats can also suffer heart diseases, often leading to an enlargement of the left atrium that promotes stagnant blood flow, activating the clotting process and promoting feline aortic thromboembolism. The majority of pathological feline hearts have echocardiographic evidence of abnormal left ventricular filling, usually assessed with 2D and Doppler echocardiography and standard imaging tools. Actually, veterinary professionals have limited access to advanced computational techniques that would enable a better understanding of feline heart pathologies with improved morphological and haemodynamic descriptors. In this work, we applied state-of-the-art image processing and computational fluid simulations based on micro-computed tomography images acquired in 24 cases, including normal cats and cats with varying severity of cardiomyopathy. The main goal of the study was to identify differences in the LA/LAA morphologies and blood flow patterns in the analysed cohorts with respect to thrombus formation and cardiac pathology. The obtained results show significant differences between normal and pathological feline hearts, as well as in thrombus vs non-thrombus cases and asymptomatic vs symptomatic cases, while it was not possible to discern in congestive heart failure with thrombus and from non-thrombus cases. Additionally, in-silico fluid simulations demonstrated lower LAA blood flow velocities and higher thrombotic risk in the thrombus cases.