Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models

Abstract Stroke is a life threatening event that is expected to more than double over the next 40 years. Atrial fibrillation (AF) has been reported as a strong independent risk factor for stroke. We have previously shown that a hemodynamic perturbation by AF or reduced cardiac output and cycle lengt...

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Main Authors: Hyo Won Choi, Tong Luo, Jose A. Navia, Ghassan S. Kassab
Format: Article
Language:English
Published: Nature Portfolio 2017-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-017-06681-3
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author Hyo Won Choi
Tong Luo
Jose A. Navia
Ghassan S. Kassab
author_facet Hyo Won Choi
Tong Luo
Jose A. Navia
Ghassan S. Kassab
author_sort Hyo Won Choi
collection DOAJ
description Abstract Stroke is a life threatening event that is expected to more than double over the next 40 years. Atrial fibrillation (AF) has been reported as a strong independent risk factor for stroke. We have previously shown that a hemodynamic perturbation by AF or reduced cardiac output and cycle length may have a significant impact on clot trajectory and thus embolic stroke propensity through the left common carotid artery using an idealized aortic arch model. Here, we show the dependence of flow patterns and hence stroke propensity on geometry of patient-specific aortas. We performed computational fluid dynamics (CFD) simulations to determine the variations of AF-induced stroke propensity over various image-based patient-dependent aorta models. The results demonstrated that curvature pattern of aorta can play a determinant role in AF-induced stroke propensity alteration. Specifically, it was shown that the hemodynamic perturbation by AF considered led to substantial increase in stroke propensity (i.e., 2.5~3.8 fold elevation) for lower curvature angle <90° while the changes in stroke propensity by AF are negligible for higher curvature angle >90°. The present simulations suggest that aortic arch curvature is an important risk factor for embolic stroke which should be tested in future clinical trials.
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spelling doaj.art-b50655e112a64bf0a974d58ed21ea27b2022-12-21T21:20:30ZengNature PortfolioScientific Reports2045-23222017-08-01711910.1038/s41598-017-06681-3Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific ModelsHyo Won Choi0Tong Luo1Jose A. Navia2Ghassan S. Kassab3The California Medical Innovations InstituteThe California Medical Innovations InstituteDepartment of Surgery, Austral UniversityThe California Medical Innovations InstituteAbstract Stroke is a life threatening event that is expected to more than double over the next 40 years. Atrial fibrillation (AF) has been reported as a strong independent risk factor for stroke. We have previously shown that a hemodynamic perturbation by AF or reduced cardiac output and cycle length may have a significant impact on clot trajectory and thus embolic stroke propensity through the left common carotid artery using an idealized aortic arch model. Here, we show the dependence of flow patterns and hence stroke propensity on geometry of patient-specific aortas. We performed computational fluid dynamics (CFD) simulations to determine the variations of AF-induced stroke propensity over various image-based patient-dependent aorta models. The results demonstrated that curvature pattern of aorta can play a determinant role in AF-induced stroke propensity alteration. Specifically, it was shown that the hemodynamic perturbation by AF considered led to substantial increase in stroke propensity (i.e., 2.5~3.8 fold elevation) for lower curvature angle <90° while the changes in stroke propensity by AF are negligible for higher curvature angle >90°. The present simulations suggest that aortic arch curvature is an important risk factor for embolic stroke which should be tested in future clinical trials.https://doi.org/10.1038/s41598-017-06681-3
spellingShingle Hyo Won Choi
Tong Luo
Jose A. Navia
Ghassan S. Kassab
Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
Scientific Reports
title Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
title_full Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
title_fullStr Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
title_full_unstemmed Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
title_short Role of Aortic Geometry on Stroke Propensity based on Simulations of Patient-Specific Models
title_sort role of aortic geometry on stroke propensity based on simulations of patient specific models
url https://doi.org/10.1038/s41598-017-06681-3
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AT ghassanskassab roleofaorticgeometryonstrokepropensitybasedonsimulationsofpatientspecificmodels