Three Dimensional Flow in the Human Left Atrium
Overview
Affiliations
Background: Abnormal flow patterns in the left atrium in atrial fibrillation or mitral stenosis are associated with an increased risk of thrombosis and systemic embolisation; the characteristics of normal atrial flow that avoid stasis have not been well defined.
Objectives: To present a three dimensional particle trace visualisation of normal left atrial flow in vivo, constructed from flow velocities in three dimensional space.
Methods: Particle trace visualisation of time resolved three dimensional magnetic resonance imaging velocity measurements was used to provide a display of intracardiac flow without the limitations of angle sensitivity or restriction to imaging planes. Global flow patterns of the left atrium were studied in 11 healthy volunteers.
Results: In all subjects vortical flow was observed in the atrium during systole and diastolic diastasis (mean (SD) duration of systolic vortex, 280 (77) ms; and of diastolic vortex, 256 (118) ms). The volume incorporated and recirculated within the vortices originated predominantly from the left pulmonary veins. Inflow from the right veins passed along the vortex periphery, constrained between the vortex and the atrial wall.
Conclusions: Global left atrial flow in the normal human heart comprises consistent patterns specific to the phase of the cardiac cycle. Separate paths of left and right pulmonary venous inflow and vortex formation may have beneficial effects in avoiding left atrial stasis in the normal subject in sinus rhythm.
Yi W, Otani T, Endo S, Wada S Front Cardiovasc Med. 2024; 10:1305526.
PMID: 38250033 PMC: 10796777. DOI: 10.3389/fcvm.2023.1305526.
Pulmonary vein flow split effects in patient-specific simulations of left atrial flow.
Duran E, Garcia-Villalba M, Martinez-Legazpi P, Gonzalo A, McVeigh E, Kahn A Comput Biol Med. 2023; 163:107128.
PMID: 37352639 PMC: 10529707. DOI: 10.1016/j.compbiomed.2023.107128.
Kessler Iglesias C, Pouliopoulos J, Thomas L, Hayward C, Jabbour A, Fatkin D Front Cardiovasc Med. 2023; 10:1099625.
PMID: 37063965 PMC: 10102662. DOI: 10.3389/fcvm.2023.1099625.
Elias A, Khoury Y, Shehadeh F, Ron G, Boulos M, Nashashibi J Res Pract Thromb Haemost. 2023; 7(2):100127.
PMID: 37063762 PMC: 10099305. DOI: 10.1016/j.rpth.2023.100127.
Zang L, Gu K, Ji X, Zhang H, Yan S, Wu X J Cardiovasc Dev Dis. 2023; 10(2).
PMID: 36826552 PMC: 9968112. DOI: 10.3390/jcdd10020056.