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September 17, 2026Medical Engineering & PhysicsOpen Access

Volume-constrained wall-motion prescription increases mean LAA wall shear stress ~400% vs static-wall CFD approximations.

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Population

Patient-specific left atrium and left atrial appendage geometry combined with literature-informed phasic…

Comparison

Reduced-order, volume-constrained wall-motion… vs Static-wall approximation

Design

Preclinical

Key result

Volume-constrained wall-motion prescription in a DD II CFD model increased mean LAA time-averaged wall shear stress from 0.01 to 0.05 Pa compared to a static-wall approximation.

Authors

JSJoão L. SilvaJMJúlio Gallinaro MaranhoRARodrigo L. Amaral

Discussion

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Overview

May refine LAA shear estimates in CFD models; extends dynamic approaches but leaves clinical translation open.

Key Points

  • To determine whether applying a reduced-order, volume-constrained wall-motion model alters computed hemodynamic descriptors in the left atrium and left atrial appendage relative to a static-wall assumption.
  • Simulated fluid dynamics within a patient-specific left atrium and left atrial appendage geometry under healthy dynamic, grade-II diastolic dysfunction (DD II) dynamic, and DD II static configurations.
  • Applied literature-derived phasic volume constraints, boundary conditions, and a laminar solver across five cardiac cycles with a time step of 10⁻³ s.
  • Suppressing DD II wall motion reduced mean left atrial appendage time-averaged wall shear stress (TAWSS) from 0.05 to 0.01 Pa and increased the atrial surface area exhibiting TAWSS < 0.1 Pa from 14.4% to 22.4%.
  • Static DD II conditions decreased median complete-wall TAWSS from 0.570 to 0.349 Pa while increasing oscillatory shear index (0.121 to 0.190), relative residence time (2.52 to 5.02 Pa⁻¹), and endothelial cell activation potential (0.217 to 0.539 Pa⁻¹).
  • Volume stasis persisting below 0.10 m/s for at least 90% of the cardiac cycle rose from 28.5% in the dynamic DD II model to 33.8% in the static configuration.

Structured PICO

P
Population
Patient-specific left atrium (LA) and left atrial appendage (LAA) geometry combined with literature-informed phasic volumes and boundary conditions
I
Intervention
Reduced-order, volume-constrained wall-motion prescription (dynamic configuration)
C
Comparator
Static-wall approximation
O
Outcome
Computed LA/LAA hemodynamic descriptors (time-averaged wall shear stress, oscillatory shear index, relative residence time, endothelial cell activation potential, volume stasis)surrogate

Main Result

Absolute Event Rate: 0.05% vs 0.01%

Volume-constrained wall motion in computational fluid dynamics models significantly alters computed LA/LAA hemodynamic descriptors compared to static-wall approximations, shifting the environment toward lower shear and greater stasis.

Limitations

  • Volume-constrained motion is not a validated surrogate for regional atrial motion or a patient-specific predictor of thrombosis.
  • Not a validated surrogate for regional atrial motion
  • Not a patient-specific predictor of thrombosis

Cite This Study

Silva et al. (2026) studied Grade-II diastolic dysfunction (DD II). Volume-constrained wall-motion prescription (dynamic configuration) vs. Static-wall approximation was evaluated on Mean LAA time-averaged wall shear stress (TAWSS). Volume-constrained wall-motion prescription in a DD II CFD model increased mean LAA time-averaged wall shear stress from 0.01 to 0.05 Pa compared to a static-wall approximation.

synapsesocial.com/papers/6aabb6635f706d05830e4cb0https://doi.org/10.1088/1873-4030/aea6df
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