Fluid-structure interaction analysis of the thromboembolic risk in the left atrial appendage under atrial fibrillation: Effect of hemodynamics and morphological features.

BACKGROUND: Complications of atrial fibrillation (AF) include ischemic events originating within the left atrial appendage (LAA), a protrusion of the left atrium with variable morphological characteristics. The role of the patient specific morphology and pathological haemodynamics on the risk of ischemia remains unclear. METHODS: This work performs a comparative assessment of the hemodynamic parameters among patient-specific LAA morphologies through fluid-structure interaction computational analyses. Three LAA models per each of the four commons patient-specific morphological families (chicken wing, cactus, windsock, and cauliflower) were analysed. Mechanical properties of the tissue were based on experimental uniaxial tests on a young pig's heart. Boundary conditions were imposed based on clinical assessments of filling and emptying volumes. Sinus rhythm and atrial fibrillation operative conditions were simulated and analysed. RESULTS: For each model, the effect of morphological and functional parameters, such as the number of trabeculae and LAA stroke volume, over the hemodynamics established into the appendage was analysed. Comparison between results obtained in healthy and diseased conditions suggested the introduction of a new parameter to quantify the risk of thrombosis, here called blood stasis factor (BSF). This is defined as the LAA surface area which permanently experiences levels of shear strain rate inferior to a threshold value, set to 5 s-1 (BSF5). CONCLUSIONS: This work suggests that the current morphological classification is unsuitable to evaluate the probability of thrombus formation. However, hemodynamic parameters easy to determine from clinical examinations, such as normalised stroke volume, LAA orifice flow rate and presence of extensive trabeculations can identify departures from healthy hemodynamics in AF and support a more systematic stratification of the thromboembolic risk.

The Role of Patient-Specific Morphological Features of the Left Atrial Appendage on the Thromboembolic Risk Under Atrial Fibrillation.

Background: A large majority of thrombi causing ischemic complications under atrial fibrillation (AF) originate in the left atrial appendage (LAA), an anatomical structure departing from the left atrium, characterized by a large morphological variability between individuals. This work analyses the hemodynamics simulated for different patient-specific models of LAA by means of computational fluid-structure interaction studies, modeling the effect of the changes in contractility and shape resulting from AF. Methods: Three operating conditions were analyzed: sinus rhythm, acute atrial fibrillation, and chronic atrial fibrillation. These were simulated on four patient-specific LAA morphologies, each associated with one of the main morphological variants identified from the common classification: chicken wing, cactus, windsock, and cauliflower. Active contractility of the wall muscle was calibrated on the basis of clinical evaluations of the filling and emptying volumes, and boundary conditions were imposed on the fluid to replicate physiological and pathological atrial pressures, typical of the various operating conditions. Results: The LAA volume and shear strain rates were analyzed over time and space for the different models. Globally, under AF conditions, all models were well aligned in terms of shear strain rate values and predicted levels of risk. Regions of low shear rate, typically associated with a higher risk of a clot, appeared to be promoted by sudden bends and focused at the trabecule and the lobes. These become substantially more pronounced and extended with AF, especially under acute conditions. Conclusion: This work clarifies the role of active and passive contraction on the healthy hemodynamics in the LAA, analyzing the hemodynamic effect of AF that promotes clot formation. The study indicates that local LAA topological features are more directly associated with a thromboembolic risk than the global shape of the appendage, suggesting that more effective classification criteria should be identified.

Basalt Fiber Hybridization Effects on High-Performance Sisal-Reinforced Biocomposites.

The increasing attention given to environmental protection, largely through specific regulations on environmental impact and the recycling of materials, has led to a considerable interest of researchers in biocomposites, materials consisting of bio-based or green polymer matrixes reinforced by natural fibers. Among the various reinforcing natural fibers, sisal fibers are particularly promising for their good mechanical properties, low specific weight and wide availability on the current market. As proven in literature by various authors, the hybridization of biocomposites by synthetical fibers or different natural fibers can lead to an interesting improvement of the mechanical properties or, in turn, of the strength against environmental agents. Consequently, this can lead to a significant enlargement of their practical applications, in particular from quite common non-structural applications (dashboards, fillings, soundproofing, etc.) towards semi-structural (panels, etc.) and structural applications (structural elements of civil construction and/or machine components). Hybridizations with natural fibers or with ecofriendly basalt fibers are the most interesting ones, since they permit the improvement of the biocomposite's performance without an appreciable increment on environmental impact, as occurs instead for synthetic fiber hybridizations that are also widely proposed in the literature. In order to further increase the mechanical performance and, above all, to reduce the aging effects on high-performance sisal-reinforced biocomposites due to environmental agents, the hybridization of such biocomposites with basalt fibers are studied with tensile, compression and delamination tests performed by varying the exposition to environmental agents. In brief, the experimental analysis has shown that hybridization can lead to further enhancements of mechanical performance (strength and stiffness) that increase with basalt volume fraction and can lead to appreciable reductions in the aging effects on mechanical performance by simple hybridization of the surface laminae. Therefore, such a hybridization can be advantageously used in all practical outdoor applications in which high-performance sisal biocomposites can be exposed to significant environmental agents (temperature, humidity, UV).

New Concept in Bioderived Composites: Biochar as Toughening Agent for Improving Performances and Durability of Agave-Based Epoxy Biocomposites.

Biocomposites are increasingly used in the industry for the replacement of synthetic materials, thanks to their good mechanical properties, being lightweight, and having low cost. Unfortunately, in several potential fields of structural application their static strength and fatigue life are not high enough. For this reason, several chemical treatments on the fibers have been proposed in literature, although still without fully satisfactory results. To overcome this drawback, in this study we present a procedure based on the addition of a carbonaceous filler to a green epoxy matrix reinforced by Agave sisalana fibers. Among all carbon-based materials, biochar was selected for its environmental friendliness, along with its ability to improve the mechanical properties of polymers. Different percentages of biochar, 1, 2, and 4 wt %, were finely dispersed into the resin using a mixer and a sonicator, then a compression molding process coupled with an optimized thermomechanical cure process was used to produce a short fiber biocomposite with Vf = 35%. Systematic experimental tests have shown that the presence of biochar, in the amount 2 wt %, has significant effects on the matrix and fiber interphase, and leads to an increase of up to three orders of magnitude in the fatigue life, together with an appreciable improvement in static tensile strength.

Analysis of the Parameters Affecting the Stiffness of Short Sisal Fiber Biocomposites Manufactured by Compression-Molding.

The use of natural fiber-based composites is on the rise in many industries. Thanks to their eco-sustainability, these innovative materials make it possible to adapt the production of components, systems and machines to the increasingly stringent regulations on environmental protection, while at the same time reducing production costs, weight and operating costs. Optimizing the mechanical properties of biocomposites is an important goal of applied research. In this work, using a new numerical approach, the effects of the volume fraction, average length, distribution of orientation and curvature of fibers on the Young's modulus of a biocomposite reinforced with short natural fibers were studied. Although the proposed approach could be applied to any biocomposite, sisal fibers and an eco-sustainable thermosetting matrix (green epoxy) were considered in both simulations and the associated experimental assessment. The results of the simulations showed the following effects of the aforementioned parameters on Young's modulus: a linear growth with the volume fraction, nonlinear growth as the length of the fibers increased, a reduction as the average curvature increased and an increase in stiffness in the x-y plane as the distribution of fiber orientation in the z direction decreased.