Arrhythmia-resolved 5D Flow MRI in Atrial Fibrillation and Stroke

消除心律失常的 5D Flow MRI 在心房颤动和中风中的应用

• 批准号: 10761709
• 负责人: Justin J Baraboo
• 金额: $ 4.37万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10761709
• 关键词: 3-Dimensional; 4D MRI; Acceleration; Affect; Algorithm Design; Algorithms; Anticoagulation; Arrhythmia; Atrial Fibrillation; Biological Markers; Blood; Blood flow; Cardiac; Cardiac Volume; Cities; Clinic; Clinical; Data; Data Set; Dedications; Detection; Development; Dimensions; Ensure; Equilibrium; Evaluation; Funding; Future; Goals; Grant; Heart; Heart Atrium; Heart Rate; Hemorrhage; Image; Imaging Techniques; Impairment; In Vitro; Ischemic Stroke; Left; Left atrial structure; Length; Magnetic Resonance Imaging; Measurement; Measures; Medical; Methodology; Methods; Mites; Outcome; Patients; Persons; Phase; Pilot Projects; Population; Prevention; Protocols documentation; Pulsatile Flow; Recording of previous events; Reference Standards; Research; Research Personnel; Respiration; Risk; Risk Factors; Running; Scanning; Secondary to; Selection for Treatments; Signal Transduction; Sorting; Source; Standardization; Stroke; Techniques; Testing; Thrombus; Time; Training; Translations; Validation; Variant; Wit; auricular appendage; biomarker identification; career; clinical risk; cohort; data acquisition; embolic stroke; heart rate variability; heart rhythm; hemodynamics; image reconstruction; imaging modality; improved; in vivo; multidimensional data; predictive marker; reconstruction; recruit; respiratory; risk stratification; statistics; stroke patient; stroke risk; success

Project Summary Atrial Fibrillation is the most common sustained cardiac arrhythmia, and it is a major risk factor for ischemic stroke. This is due to thrombus formation in the left atrium which may be mitigated by anticoagulation therapy but carrying its own bleeding risk. Current clinical therapy selection strategies balancing bleeding risk of anticoagulation therapy to stroke risk lack for stroke patient The be prediction predictive power. Blood stasis is a key component of Virchow's triad thrombus formation, and flow imaging methods have shown lowered left atrial velocities are associated with risk. However, these methods either lack omprehensive 3D measurement or must reject data when the is i n arrhythmia, where both of these may be necessary to develop accurate biomarkers to predict stroke. goal of this project is to further develop and optimize an arrhythmia resolved flow imaging MRI method to able to capture the time varying 3D atrial hemodynamics during arrhythmia with the potential to develop stroke biomarkers to guide medical therapy selection. c The first aim of this proposal is development and optimization of the MRI method: arrhythmia resolved 5D flow MRI, a multi-dimensional data set of dimension: 3D spatial + cardiac time + heartbeat duration. For several heartbeat durations measured during arrhythmia (e.g. short heartbeats, long heartbeats) we will construct a 3D time varying magnitude and velocity data set for one cardiac cycle for that heartbeat duration. A pulsatile flow phantom, capable of simulating a known arrhythmia, will allow the optimization of acquisition time and image reconstruction methodology and parameters. I will develop two different reconstruction algorithms, which can be reconstructed using the same raw data. First, images will be reconstructed to measure maximum differences across the varying heart rhythm in order to analyze the heart rate variable hemodynamics within a patient. Second, images will be reconstructed based on data acquired from fixed, standardized heartbeat lengths, allowing the comparison between subjects, controlling for the effect of heartbeat duration itself. This will be tested against the reference standard, in this setting: 2D real time phase contrast. Clinical collaborators will help with algorithm design of the optimized imaging reconstruction to ensure success of in vitro to in vivo translation of the technique from the first aim to subsequent aims. The second aim will validate this technique in vivo with a cohort of 10 healthy controls and 10 persistent atrial fibrillation patients. This will also establish heart rate variable and controlled hemodynamic differences between these groups. In the third aim, we will test the abilities of the method to discriminate between stroke history and no stroke history atrial fibrillation patients. 12 persistent atrial fibrillation patients with prior cardioembolic stroke history and 12 persistent atrial fibrillation patients without a stroke history will be recruited. The goal of this aim is to see differences in atrial hemodynamics between groups as a precursor to developing an atrial hemodynamic biomarker to improve medical therapy selection.

项目摘要 心房颤动是最常见的持续性心律不齐，它是缺血的主要危险因素 中风。这是由于左心房中的血栓形成，可以通过抗凝治疗缓解 但承担自己的出血风险。当前的临床治疗选择策略平衡出血风险 抗凝疗法以缺乏中风风险 为了 中风 病人 这 是 预言 预测能力。血迹是Virchow Triad的关键组成部分 血栓形成，流成像方法已显示出降低的左心房速度与 风险。但是，这些方法要么缺乏相当大的3D测量，要么必须拒绝 是心律失常，在这里可能需要两者来开发准确的生物标志物来预测中风。 该项目的目标是进一步开发和优化心律不齐的流动成像MRI方法 能够在心律不齐期间捕获变化的3D心房血流动力学的时间，并可能发展为中风 引导医疗疗法选择的生物标志物。 c 该提案的第一个目的是MRI方法的开发和优化：心律不齐5D流动 MRI，一个多维数据集：3D空间 +心脏时间 +心跳持续时间。几个 心律不齐期间测量的心跳持续时间（例如短心跳，长心跳），我们将构建一个3D 在心跳持续时间内，时间为一个心脏周期的时间变化和速度数据集。脉动流动 能够模拟已知心律不齐的幻影，将允许优化采集时间和图像 重建方法和参数。我将开发两种不同的重建算法，可以是 使用相同的原始数据重建。首先，将重建图像以测量最大差异 为了分析患者内心率可变的血液动力学，在各种心脏节奏之间。 其次，将根据从固定的标准化心跳长度获得的数据重建图像， 允许受试者之间的比较，控制心跳持续时间本身的影响。这将进行测试 在参考标准中，在此设置：2D实时阶段对比度。临床合作者将帮助 优化成像重建的算法设计，以确保体外成功到体内翻译 从第一个目标到随后的目标的技术。第二个目标将在体内验证该技术 在10个健康对照和10名持续性房颤患者中。这也将建立心率变量，并且 这些组之间的血液动力学差异。在第三个目标中，我们将测试 区分中风病史和无中风病史心房颤动患者的方法。 12持续的房屋 具有先前心肌卒中史的纤颤患者和12名没有A的持续性房颤患者 中风历史将被招募。这个目的的目的是查看组之间房屋动力学的差异 作为开发心房血液动力学生物标志物以改善医疗疗法选择的先驱。