{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:47:21Z","timestamp":1781635641375,"version":"3.54.5"},"update-to":[{"DOI":"10.1371\/journal.pcbi.1013656","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000}}],"reference-count":107,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000275","name":"Leverhulme Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/24\/130023"],"award-info":[{"award-number":["RE\/24\/130023"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/20\/4\/34803"],"award-info":[{"award-number":["RG\/20\/4\/34803"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012338","name":"Alan Turing Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012338","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/20\/26\/34952"],"award-info":[{"award-number":["FS\/20\/26\/34952"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/M012492\/1, NS\/A000049\/1, and EP\/P01268X\/1"],"award-info":[{"award-number":["EP\/M012492\/1, NS\/A000049\/1, and EP\/P01268X\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["PG\/15\/91\/31812, PG\/13\/37\/30280, SP\/18\/6\/33805"],"award-info":[{"award-number":["PG\/15\/91\/31812, PG\/13\/37\/30280, SP\/18\/6\/33805"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIH R01-HL152256"],"award-info":[{"award-number":["NIH R01-HL152256"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Research Council","award":["ERC PREDICT-HF 864055"],"award-info":[{"award-number":["ERC PREDICT-HF 864055"]}]},{"DOI":"10.13039\/100012338","name":"Alan Turing Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012338","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>\n                    In atrial fibrillation (AF), atrial biomechanics are altered, reducing atrial movement. It remains unclear whether these changes are due to altered anatomy, myocardial stiffness, or constraints from surrounding structures. Understanding the causes of changed atrial deformation in AF could enhance tissue characterization and inform AF diagnosis, stratification, and treatment. We created patient-specific anatomical models of the left atrium (LA) from CT images. Passive LA biomechanics were simulated using finite deformation continuum mechanics equations. LA stiffness was represented by the Guccione material law, where\n                    <jats:italic>\u03b1<\/jats:italic>\n                    scaled the anisotropic stiffness parameters. Regional passive stiffness parameters were calibrated to peak regional deformation during the reservoir phase and validated against deformation transients derived from retrospective gated CT images during the reservoir and conduit phase. Physiological LA deformation varies regionally, with the roof deforming significantly less than other regions during the reservoir phase. The fitted model matched peak patient deformations globally and regionally with an average error of\n                    <jats:inline-formula id=\"pcbi.1013656.e001\">\n                      <jats:alternatives>\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pcbi.1013656.e001g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pcbi.1013656.e001\" xlink:type=\"simple\"\/>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M1\">\n                          <mml:mrow>\n                            <mml:mn>0.90<\/mml:mn>\n                            <mml:mo>\u00b1<\/mml:mo>\n                            <mml:mn>0.39<\/mml:mn>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    mm over our cohort. We compared deformation transients through the reservoir and conduit phases and found that the simulated deformation transients were within an average of\n                    <jats:inline-formula id=\"pcbi.1013656.e002\">\n                      <jats:alternatives>\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" id=\"pcbi.1013656.e002g\" mimetype=\"image\" position=\"anchor\" xlink:href=\"info:doi\/10.1371\/journal.pcbi.1013656.e002\" xlink:type=\"simple\"\/>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"M2\">\n                          <mml:mrow>\n                            <mml:mo>\u00b1<\/mml:mo>\n                            <mml:mn>0.38<\/mml:mn>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:alternatives>\n                    <\/jats:inline-formula>\n                    mm per unit time of the CT-derived deformation transients. Regional stiffness varied across the atria with average\n                    <jats:italic>\u03b1<\/jats:italic>\n                    values of 1.8, 1.6, 2.2, 1.6 and 2.1 across the cohort in the anterior, posterior, septum, lateral and roof regions respectively. Using mixed effect models, we found no correlation between regional patient LA deformation and regional estimates of wall thickness or regional volumes of epicardial adipose tissue. We found a significant correlation between regionally calibrated stiffness and CT-derived LA biomechanics (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.023). We have shown that regional heterogeneity in stiffness contributes to regional LA biomechanics, while anatomical features appeared less important. These findings provide insight into the underlying causes of altered LA biomechanics in AF.\n                  <\/jats:p>","DOI":"10.1371\/journal.pcbi.1013656","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T18:44:42Z","timestamp":1762368282000},"page":"e1013656","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Regional heterogeneity in left atrial stiffness impacts passive deformation in a cohort of patient-specific models"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3157-3568","authenticated-orcid":true,"given":"Tiffany M.G.","family":"Baptiste","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7921-7840","authenticated-orcid":true,"given":"Cristobal","family":"Rodero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles P.","family":"Sillett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Strocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Lanyon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6341-4014","authenticated-orcid":true,"given":"Christoph M.","family":"Augustin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela W. C.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Alonso","family":"Sol\u00eds-Lemus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline H.","family":"Roney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Ennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronak","family":"Rajani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7380-6908","authenticated-orcid":true,"given":"Gernot","family":"Plank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D.","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7266-2084","authenticated-orcid":true,"given":"Steven E.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Niederer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"issue":"2","key":"pcbi.1013656.ref001","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1093\/ehjqcco\/qcaa093","article-title":"Atrial fibrillation in the UK: predicting costs of an emerging epidemic recognizing and forecasting the cost drivers of atrial fibrillation-related costs","volume":"8","author":"P Burdett","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes."},{"issue":"1","key":"pcbi.1013656.ref002","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41572-022-00347-9","article-title":"Atrial fibrillation","volume":"8","author":"BJJM Brundel","year":"2022","journal-title":"Nat Rev Dis Primers."},{"key":"pcbi.1013656.ref003","doi-asserted-by":"crossref","unstructured":"Kirchhof P. 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