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.

项目概要 心房颤动是最常见的持续性心律失常，是缺血性心律失常的主要危险因素 中风。这是由于左心房形成血栓，抗凝治疗可减轻血栓形成 但也有其自身的出血风险。当前临床治疗选择策略平衡出血风险 缺乏针对中风风险的抗凝治疗 为了 中风 病人 这 是 预言 预测能力。血瘀是魏尔啸三联征的重要组成部分 血栓形成和血流成像方法显示左心房流速降低与 风险。然而，这些方法要么缺乏全面的 3D 测量，要么在 在心律失常中，这两种可能都是开发准确的生物标志物来预测中风所必需的。 该项目的目标是进一步开发和优化心律失常解决血流成像 MRI 方法，以 能够捕捉心律失常期间随时间变化的 3D 心房血流动力学，并有可能导致中风 指导药物治疗选择的生物标志物。 c 该提案的首要目标是 MRI 方法的开发和优化：解决心律失常的 5D 血流 MRI，维度多维数据集：3D空间+心跳时间+心跳持续时间。对于几个 在心律失常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 针对该心跳持续时间的一个心动周期的随时间变化的幅度和速度数据集。脉动流 能够模拟已知心律失常的体模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 跨越不同的心律，以分析患者体内心率变化的血流动力学。 其次，图像将根据从固定的标准化心跳长度获取的数据进行重建， 允许在受试者之间进行比较，控制心跳持续时间本身的影响。这将被测试 对照参考标准，在此设置中：2D 实时相位对比。临床合作者将提供帮助 优化成像重建的算法设计，以确保体外到体内翻译的成功 从第一个目标到后续目标的技术。第二个目标是通过队列在体内验证该技术 10 名健康对照者和 10 名持续性房颤患者。这也将建立心率变量和 控制这些组之间的血流动力学差异。在第三个目标中，我们将测试参与者的能力。 区分中风病史和无中风病史的房颤患者的方法。 12 持续性心房 既往有心源性卒中病史的颤动患者和 12 名没有既往史的持续性房颤患者 将招募中风病史。该目的的目的是观察各组之间心房血流动力学的差异 作为开发心房血流动力学生物标志物以改善药物治疗选择的先驱。