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Changes in Global and Regional Mechanics Due to Atrial Fibrillation: Insights from a Coupled Finite-Element and Circulation Model

Moyer, Christian ; Norton, Patrick ; Ferguson, John ; Holmes, Jeffrey

In: Annals of Biomedical Engineering, 2015, vol. 43, no. 7, p. 1600-1613

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    Titre
    • Changes in Global and Regional Mechanics Due to Atrial Fibrillation: Insights from a Coupled Finite-Element and Circulation Model
    Auteur
    • Moyer, Christian. Department of Biomedical Engineering, University of Virginia, P.O Box 800759, 22908, Charlottesville, VA, USA
    • Norton, Patrick. Department of Radiology, University of Virginia, Charlottesville, VA, USA
    • Ferguson, John. Department of Medicine, University of Virginia, Charlottesville, VA, USA
    • Holmes, Jeffrey. Department of Biomedical Engineering, University of Virginia, P.O Box 800759, 22908, Charlottesville, VA, USA
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Biomedical Engineering, 2015, vol. 43, no. 7, p. 1600-1613. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332110
    Summary
    Atrial fibrillation (AF) is a rhythm disorder with rapidly increasing prevalence due to the aging of the population. AF triggers structural remodeling and a gradual loss of function; however, the relative contributions of specific features of AF-induced remodeling to changes in atrial mechanical function are unclear. We constructed and validated a finite-element model (FEM) of the normal human left atrium using anatomic information from cardiac magnetic resonance imaging, material properties and fiber orientations from published studies, and an iterative algorithm to estimate unloaded geometry. We coupled the FEM to a circuit model to capture hemodynamic interactions between the atrium, pulmonary circulation, and left ventricle. The normal model reproduced measured volumes within 1 SD, as well as most metrics of regional mechanics. Using this validated human model as a starting point, we explored the impact of individual features of atrial remodeling on atrial mechanics and found that a combination of dilation, increased pressure, and fibrosis can explain most of the observed changes in mechanics in patients with paroxysmal AF. However, only impaired ventricular relaxation could reproduce the increased reliance on active emptying we observed in these patients. The resulting model provides new insight into the mechanics of AF and a platform for exploring future therapies.