Detection of Left Ventricular Dyssynchrony by Cross-Correlation Analysis

通过互相关分析检测左心室不同步

• 批准号: 7820899
• 负责人: JOHN N OSHINSKI
• 金额: $ 2.79万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2010-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7820899
• 关键词: Acute; Admission activity; Artificial cardiac pacemaker; Cardiac; Cardiac Output; Clinical; Data; Data Set; Databases; Detection; Diagnosis; Diastole; EFRAC; EKG QRS Complex; Electrocardiogram; Heart; Heart failure; Hospitals; Image; Lead; Left; Measures; Mechanics; Methodology; Methods; Mitral Valve Insufficiency; Multi-Institutional Clinical Trial; Myocardial Contraction; Myocardial tissue; Myocardium; Outcome; Pacemakers; Patient Selection; Patients; Performance; Pharmaceutical Preparations; Publishing; Receiver Operating Characteristics; Refractory; Relaxation; Reporting; Research Personnel; Sensitivity and Specificity; Severities; Surface; Testing; Time; Tissues; United States; Ventricular; Ventricular Function; Ventricular Remodeling; base; computerized data processing; hemodynamics; implantation; improved; inclusion criteria; normal aging; novel; response; tool

Project Summary In thirty percent of patients with severe, drug-refractory heart failure, regional timing of myocardial contraction and relaxation is dyssynchronous. This mechanical dyssynchrony leads to adverse ventricular remodelling, increased mitral regurgitation, and reduced ejection fraction. Cardiac resynchronization therapy (CRT) is a relatively new treatment for heart failure patients with dyssynchrony that results in both acute hemodynamic benefit as well as improved long-term outcome. Despite CRT showing benefits in many multi- center clinical trials, 30% of patients selected for CRT show no improvement by clinical or echocardiographic endpoints. This poor response rate may in part be explained by limitations of current methods to determine the presence and severity of dyssynchrony. To overcome the limitations of existing dyssynchrony parameters, we have developed a new mathematical method to calculate a temporal delay between two myocardial tissue velocity profiles acquired with tissue Doppler imaging (TDI). Our method utilizes a function to quantify either systolic, diastolic, or whole- cycle delays using TDI data collected throughout the cardiac cycle. The objectives of this study are to evaluate the ability of our method to: 1) quantify mechanical dyssynchrony in the heart, and 2) predict response to CRT. Preliminary data in a group of young, healthy, normal subjects (negative controls) and known responders to CRT (positive controls) indicate excellent sensitivity and specificity of the methodology. The central hypothesis of this study is that our method of determining dyssynchrony delays is more sensitive and specific in selecting patients who respond to CRT compared to currently utilized methods. To test the hypothesis, we will utilize an existing data set of from a large, multi-center CRT trial (PROSPECT trial). The specific aims of this project are: 1) Quantify systolic, diastolic and whole-cycle delays in a group on normal, aged-matched subjects (negative controls) and compare delay values in these subjects to delay values in a group known responders to CRT (positive controls). 2) Evaluate the ability of systolic, diastolic, and whole-cycle delays to predict response to CRT using an existing large, multi-center database of 260 patients. Project Narrative We propose to develop and test a new method to improve selection of patients who will benefit from cardiac pacemaker implantation. The methodology uses signal processing methods based on echocardiographic image data. We will use images from an existing database of 260 subjects. The method would improve patient selection so only subjects who would benefit from pacemaker implantation would be identified, and all subjects who would benefit from a pacemaker would be identified.

项目摘要 在患有严重毒品的心力衰竭的患者中，有30％的心肌时间安排 收缩和放松是同步的。这种机械性障碍会导致心室不良 重塑，二尖瓣反流的增加和射血分数减少。心脏重新同步疗法 （CRT）是一种相对较新的治疗方法，可用于患有性障碍的心力衰竭患者，这两种急性 血液动力学益处以及改善的长期结果。尽管CRT在许多多人中都显示出好处 中心临床试验，被选为CRT的患者中有30％显示出临床或超声心动图的改善 端点。这种较差的应答率可能部分通过当前方法的局限性来解释 异议障碍的存在和严重程度。 为了克服现有异位障碍参数的局限性，我们开发了一个新的 计算两个心肌组织速度之间的时间延迟的数学方法 与组织多普勒成像（TDI）。我们的方法利用一个函数来量化收缩期，舒张压或整体 使用在整个心脏周期收集的TDI数据的周期延迟。这项研究的目标是评估 我们方法的能力：1）量化心脏中的机械性障碍，以及2）预测对CRT的反应。 一组年轻，健康，正常受试者（阴性对照）和已知响应者的初步数据 CRT（阳性对照）表明该方法的敏感性和特异性出色。中心假设 这项研究的是，我们确定异步延迟的方法在选择方面更加敏感和特异性 与当前使用方法相比，对CRT做出反应的患者。为了检验假设，我们将利用 来自大型多中心CRT试验的现有数据集（前景试验）。该项目的具体目的是： 1）在正常，年龄匹配的受试者的组中量化收缩期，舒张期和全周期延迟 （负面对照）并比较这些受试者的延迟值与已知组中的延迟值延迟值 响应者对CRT（阳性对照）。 2）评估收缩期，舒张压和全周期延迟的能力，以预测使用CRT的反应 现有的大型多中心数据库，由260位患者组成。项目叙述 我们建议开发和测试一种新方法，以改善将受益于心脏的患者的选择 起搏器植入。该方法使用基于超声心动图的信号处理方法 图像数据。我们将使用来自260个主题的现有数据库中的图像。该方法将改善 患者选择，因此只有从起搏器植入中受益的受试者才能被确定，所有的受试者 将确定将从起搏器中受益的受试者。

项目成果

Cardiovascular magnetic resonance at 3.0 T: current state of the art.

• DOI: 10.1186/1532-429x-12-55
• 发表时间: 2010-10-07
• 期刊: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
• 作者: Oshinski JN;Delfino JG;Sharma P;Gharib AM;Pettigrew RI
• 通讯作者: Pettigrew RI

Time-resolved analysis of coronary vein motion and cross-sectional area.

• DOI: 10.1002/jmri.22674
• 发表时间: 2011-10
• 期刊: JOURNAL OF MAGNETIC RESONANCE IMAGING
• 影响因子: 4.4
• 作者: Suever, Jonathan D.;Watson, Pierre J.;Eisner, Robert L.;Lerakis, Stamatios;O'Donnell, Robert E.;Oshinski, John N.
• 通讯作者: Oshinski, John N.

It's time for a paradigm shift in the quantitative evaluation of left ventricular dyssynchrony.

现在是左心室不同步定量评估范式转变的时候了。

• DOI: 10.1016/j.echo.2009.04.012
• 发表时间: 2009
• 期刊: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
• 作者: Fornwalt,BrandonK;Delfino,JanaG;Sprague,WilliamW;Oshinski,JohnN
• 通讯作者: Oshinski,JohnN