Comprehensive analysis of endocardial strain using 4DCT data

利用4DCT数据综合分析心内膜应变

• 批准号: 9910485
• 负责人: Gabrielle M. Colvert
• 金额: $ 3.79万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9910485
• 关键词: 3-Dimensional; Achievement; Address; Adult; Age; Algorithms; Anatomy; Aortic Valve Stenosis; Bioprosthesis device; Blood; Cardiac; Cardiac Surgery procedures; Cardiomyopathies; Catheters; Clinical; Clinical Trials; Confidence Intervals; Consumption; Data; Devices; Diagnosis; Disease; Dose; Drops; EFRAC; Echocardiography; Eligibility Determination; Endocardium; Evaluation; Growth; Heart; Heart Diseases; Heart Rate; Heart failure; Individual; Intervention; Left; Left Ventricular Dysfunction; Left Ventricular Ejection Fraction; Left Ventricular Function; Left Ventricular Remodeling; Left atrial structure; Life; Magnetic Resonance Imaging; Manuals; Maps; Measurement; Measures; Medical; Methods; Mitral Valve; Mitral Valve Insufficiency; Modality; Modeling; Modernization; Myocardial; Myocardial dysfunction; Myocardium; Noise; Normal Statistical Distribution; Operative Surgical Procedures; Outcome; Patients; Physiology; Play; Positioning Attribute; Procedures; Process; Reporting; Resolution; Risk; Role; Rotation; Shapes; Signal Transduction; Spatial Distribution; Stroke Volume; Surface; Symptoms; System; Techniques; Technology; Time; Tissues; UPK3 gene; Ventricular; Ventricular Remodeling; Visualization; aortic valve replacement; base; cohort; comorbidity; contrast enhanced; detector; experimental study; fitness; heart function; high risk; implantation; improved; improved outcome; minimally invasive; mitral valve replacement; mortality; non-invasive imaging; older patient; patient stratification; post intervention; prognostic; reconstruction; repaired; surgical risk; temporal measurement; tool; valve replacement

Project Summary Minimally invasive transcather-based procedures have emerged over the past decade as a therapy for selected patients with valvular disease as an alternative to riskier open-heart surgery, particularly in patients with high surgical risk due to multiple comorbidities. As the technology improves and successful clinical outcomes increase, lower-risk patients are likely to be eligible for these procedures as demonstrated by recent clinical trials for transcather aortic valve replacement. Noninvasive imaging, which has supported the growth of transcather interventions by providing excellent preprocedural planning, could also become useful for stratifying patients based on quantifiable prognostic parameters. For example, transcatheter mitral valve replacement (TMVR) is a relatively new minimally invasive procedure to treat mitral regurgitation (MR); however, its effect on left ventricular (LV) function has not yet been characterized. In addition, patients with secondary MR as a result of left ventricular remodeling due to ischemic or idiopathic cardiomyopathy can have a large portion of their myocardium which is already dysfunctional which requires regional characterization of LV function. The proposed project aims to evaluate the net effect of MR and implantation of the bioprosthetic valve on LV function by identifying akinetic, dyskinetic, hypokinetic and normal regions of myocardium before and 1-month post minimally invasive valve replacement using noninvasive single heartbeat 4DCT-derived metrics. It is hypothesized that the fraction and spatial distribution of normal vs. abnormal tissue will correlate with the ability of the LV to recover post intervention. Regional maps of endocardial longitudinal strain, circumferential strain, and rotation will be compared to traditional global metrics such as stroke volume and ejection fraction. In addition, we will investigate the effect of the position of the bioprosthetic mitral valve device and anchoring system upon the remodeling process of the LV by performing statistical shape modeling pre and post procedure. In order to characterize regional myocardial function as normal or abnormal with estimated confidence intervals, the precision of the 4DCT-derived measurement tools will be quantified. This project aims to evaluate the effect of spatial resolution, temporal resolution, the signal-to-noise ratio, and the patient’s heart rate on the precision of myocardial function metrics. In addition, the proposed 4DCT-derived metrics will be validated in subjects who undergo both MRI tagging and 4DCT exams within the same day.

项目摘要 在过去的十年中，基于最低侵入性的基于侵入性的转发程序已成为某些疗法 瓣膜疾病的患者可以替代风险较高的心脏外科手术，尤其是在患者中 多种合并症引起的手术风险。随着技术的改善和成功的临床结果 近期临床试验证明，增加，低危患者可能有资格参加这些程序 用于替代主动脉瓣更换。非侵入性成像，它支持了thresscather的增长 通过提供出色的预性术中计划来进行干预，也可能对分层患者有用 基于可量化的预后参数。例如，经导管二尖瓣更换（TMVR）是一个 相对新的最小侵入性治疗二尖瓣反流（MR）；但是，它对左心室的影响 （LV）尚未表征功能。此外，左心室的继发性MR的患者 由于缺血性或特发性心肌病引起的重塑 已经功能失调，需要左室功能的区域表征。 拟议的项目旨在评估MR的净效应和生物假体阀对LV的植入 通过鉴定心肌的偶联，运动障碍，低温和正常区域和1个月的功能 使用非侵入性的单个心跳4DCT衍生的指标，在​​微创瓣膜后置换。这是 假设正常组织与异常组织的分数和空间分布将与能力相关 lv恢复干预后。心内膜纵向应变的区域图，周向应变， 将旋转与传统的全球指标（例如中风量和射血分数）进行比较。此外， 我们将研究生物假体二尖瓣设备的位置的影响，并锚定系统在 通过执行统计形状建模前后，LV的重塑过程。 为了将区域心肌功能表征为正常或异常，并具有估计的置信区间， 4DCT衍生的测量工具的精度将被量化。该项目旨在评估效果 空间分辨率，临时分辨率，信噪比和患者的心率 心肌功能指标。此外，拟议的4DCT衍生指标将在受试者中得到验证 在同一天，同时接受MRI标签和4DCT考试。