What is it about?

We propose for the first time a computational fluid dynamics analysis to investigate the effects of atrial fibrillation (AF) - the most common cardiac arrhythmia - on lenticulostriate arteries (LSAs) by using 7T high-resolution magnetic resonance imaging (MRI). LSAs are small perforating arteries perpendicularly departing from the anterior and middle cerebral arteries and supplying blood flow to basal ganglia. These small arteries are involved in silent strokes, cerebral small vessel diseases, and alteration of deep cerebral hemodynamics, which are considered among the main vascular drivers and the least investigated hypotheses underlying the recent association between AF and the onset of dementia and cognitive decline.

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Why is it important?

To date, the main reason why well-established causal links between AF hemodynamics and cognitive impairment are missing is the difficulty in obtaining direct and local clinical measures, since currently adopted techniques usually fail in capturing the cerebral micro-vasculature hemodynamics. The present approach - by combining high-resolution MRI data, low-order dimensional AF modeling, and 3D computational fluid dynamics - proposes an integrated in silico-in vivo framework, to shed light into complex and unexplored mechanisms underlying important cerebral pathologies.

Perspectives

Our results reveal that AF induces a marked reduction of wall shear stress and flow velocity fields in the cerebrovascular regions investigated. The present study suggests that AF at higher heart rates leads to a more hazardous hemodynamic scenario, by increasing the atheromatosis and thrombogenesis risks in the LSAs region and potentially eliciting a higher AF-induced lacunar stroke risk. Our research aims to contribute at filling the gaps in the pathophysiological knowledge of the cerebral hemodynamics during AF and providing scientific evidence to improve clinical AF management in order to reduce its impact on cognitive decline. In this respect, a delay of the onset of dementia by just few years would have huge socio-economic implications, in terms of the patient’s quality of life and burden of health care costs. This work is the result of a synergistic and multidisciplinary collaboration exploiting competences coming from very different research areas: fluid dynamics, cardiology, and neuroimaging.

Stefania Scarsoglio
Politecnico di Torino

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This page is a summary of: Cerebral hemodynamics during atrial fibrillation: Computational fluid dynamics analysis of lenticulostriate arteries using 7 T high-resolution magnetic resonance imaging, Physics of Fluids, December 2022, American Institute of Physics,
DOI: 10.1063/5.0129899.
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