Cardiac Magnetic Resonance Imaging and Cardiac Resynchronization Therapy

心脏磁共振成像和心脏再同步治疗

基本信息

批准号：
8100435
负责人：
Kenneth C Bilchick
金额：
$ 13.52万
依托单位：
UNIVERSITY OF VIRGINIA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-17 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8100435
关键词：
Academic Medical Centers Affect Algorithms American Area Arrhythmia Caliber Cardiac Cardiopulmonary Characteristics Cicatrix Classification Clinical Clinical Investigator Clinical Research Clinical Trials Clinical assessments Coronary sinus structure Data Defibrillators Development Development Plans Doctor of Medicine Doctor of Philosophy Echocardiography Equipment Exercise stress test Fostering Foundations Goals Heart failure Hospitalization Image Imaging Techniques Implant Infarction Instruction Lead Left Left Ventricular Ejection Fraction Left ventricular structure Life Location Magnetic Resonance Magnetic Resonance Imaging Maps Master&apos s Degree Measures Mechanics Mentors Methods Metric Minnesota Morbidity - disease rate Myocardial Myocardial tissue Myocardium Pacemakers Participant Patient Selection Patients Physiologic pulse Pilot Projects Positioning Attribute Prevalence Principal Investigator Procedures Prospective Studies Protocols documentation Public Health Publishing Pump Quality of life Questionnaires Radial Relative (related person)Research Resolution Resources Right ventricular structure Site Stress Symptoms Time United States Universities Ventricular Ventricular End-Systolic Volumes Virginia abstracting base candidate selection career career development density follow-up implantation improved indexing meetings mortality novel outcome forecast reconstruction research and development response skills

项目摘要

DESCRIPTION (provided by applicant): The purpose of this proposal is to foster the scientific development and clinical research skills of Kenneth Bilchick, MD, in order that he may become an independent clinical investigator. The University of Virginia (UVA) will provide him with all the resources of this major academic medical center for this proposal, including a dedicated MR research scanner, state-of-the-art echocardiographic imaging equipment, and a fully equipped Stress lab. This proposal will serve as the foundation for the development of an independent academic career under the guidance of mentor Christopher Kramer, M.D., and co-mentor Frederick Epstein, Ph.D. Of note. Dr. Bilchick's career development plan includes completion of a Masters degree in Clinical Investigation. Heart failure (HF) is a major cause of morbidity and mortality affecting nearly 5 million Americans. Dr. Bilchick's long-term research goal is to develop and apply advanced cardiac imaging techniques to patients with heart failure and cardiac arrhythmias. Cardiac resynchronization therapy (CRT) has great potential clinical benefit for patients with HF, but is limited by difficulties identifying appropriate patients and achieving optimal left ventricular (LV) lead placement. This project employs cine DENSE (displacement encoding with stimulated echoes), a novel cardiac magnetic resonance (CMR) imaging protocol that was developed at UVA and yields very high quality strain data even in dilated and thinned left ventricles. The primary hypothesis of the proposal is that CMR with DENSE assessment of circumferential mechanical dyssynchrony and scar imaging is significantly more accurate than echocardiography in predicting CRT response, with nonresponse the likely result when the LV lead is positioned in or near significant scar. Therefore, this prospective study evaluates whether CMR DENSE assessment of the substrate for resynchronization provides more accurate determination of CRT response than echocardiography (specific aim #1) and whether LV lead sites with significant surrounding scar are associated with lack of CRT response (specific aim #2). Study participants will have clinical assessment, cardiac imaging, cardiopulmonary exercise testing, and neurohormonal assessment at baseline and 6 months after the clinical CRT procedure, as well as long-term follow-up for 3 years after CRT. RELEVANCE (See instructions): Heart failure (HF) is a major cause of morbidity and mortality with nearly 5 million Americans affected. CRT has great potential benefit for the most symptomatic HF patients, but its efficacy has been limited by difficulty identifying appropriate candidates. This study of cine DENSE CMR in patients with HF undergoing CRT is of high public health importance as it seeks to improve CRT candidate selection and optimize the procedure. (End of Abstract)

描述（由申请人提供）：该提案的目的是促进医学博士肯尼斯·比尔奇克（Kenneth Bilchick）的科学发展和临床研究技能，以便他成为独立的临床研究者。弗吉尼亚大学（UVA）将为他提供该建议的主要学术医学中心的所有资源，包括专门的研究扫描仪，最先进的超声心动图像设备和设备齐全的压力实验室。该提案将在导师克里斯托弗·克莱默（Christopher Kramer）和弗雷德里克·爱泼斯坦（Frederick Epstein）博士的指导下，为发展独立学术生涯的发展基础。值得注意。 Bilchick博士的职业发展计划包括完成临床研究硕士学位。心力衰竭（HF）是影响近500万美国人的发病率和死亡率的主要原因。 Bilchick博士的长期研究目标是为心力衰竭和心律不齐的患者开发和应用高级心脏成像技术。心脏重新同步治疗（CRT）对HF患者具有很大的潜在临床益处，但受到识别适当患者并获得最佳左心室（LV）铅铅的困难的限制。该项目采用Cine密集（用刺激回声编码的位移编码），这是一种新型的心脏磁共振（CMR）成像方案，该方案是在UVA开发的，即使在扩张且较薄的左心室中也能获得非常高质量的应变数据。该提案的主要假设是，在预测CRT响应时，对圆周机械性异构性和疤痕成像进行密集评估和疤痕成像的CMR比超声心动图明显更准确，而当LV铅位于或接近显着的疤痕中时，可能的结果可能结果。因此，这项前瞻性研究评估了CMR重密度评估是否比超声心动图（特定的目标＃1）更准确地确定CRT响应（特定目标＃1），以及周围疤痕明显的LV铅位点是否与缺乏CRT响应有关（特定的AIM AIM＃＃ 2）。研究参与者将在基线和临床CRT手术后6个月进行临床评估，心脏成像，心肺运动测试和神经激素评估，以及CRT后3年的长期随访。相关性（请参阅说明）：心力衰竭（HF）是近500万美国人受影响的发病率和死亡率的主要原因。 CRT对最有症状的HF患者具有巨大的潜在好处，但是由于难以识别适当的候选者，其功效受到了限制。这项对接受CRT患者的Cine致密CMR的研究非常重要，因为它试图改善CRT候选候选者的选择并优化程序。（抽象的结尾）