EXercise Cardiac Magnetic Resonance Assessment of Left Atrial Mechanics Following Ablation TO Reduce Atrial Fibrillation Burden and Correlation with Exercise CapacitY: EXCLAMATORY Longitudinal Study

消融后对左心房力学进行运动心脏磁共振评估以减少心房颤动负担及其与运动能力的相关性：感叹号纵向研究

• 批准号: 10740318
• 负责人: Cory Trankle
• 金额: $ 18.16万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10740318
• 关键词: Ablation; Activities of Daily Living; Affect; Arrhythmia; Atrial Fibrillation; Atrial Function; Bicycling; Cardiac; Cardiac ablation; Cardiomyopathies; Cardiopulmonary; Cardiovascular system; Clinical Research; Contracts; Data; Development; Diagnostic; Diastole; Disease; Echocardiography; Environment; Evaluation; Exercise; Exercise Physiology; Exercise Test; Exertion; Functional disorder; Future; Goals; Heart; Heart Atrium; Heart Diseases; Heart Rate; Heart failure; Impairment; Incidence; Individual; Institution; Lead; Learning; Left; Left Atrial Function; Left Ventricular Function; Left atrial structure; Literature; Longitudinal Studies; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Mentors; Methods; Modality; Oxygen Consumption; Patients; Performance; Phenotype; Positioning Attribute; Principal Investigator; Publishing; Regulation; Research; Research Methodology; Research Personnel; Research Project Grants; Rest; Risk; Role; Sinus; Stroke Volume; Structure; Supination; Techniques; Therapeutic Intervention; Training; Ventricular; Writing; cardiac magnetic resonance imaging; cardiovascular imaging; career; common treatment; design; exercise capacity; exercise intolerance; experience; heart function; high risk; improved; innovation; interest; knowledge base; multidisciplinary; noninvasive diagnosis; patient oriented; potential biomarker; programs; prospective; statistics; targeted treatment; training project

PROJECT SUMMARY Atrial fibrillation is a highly prevalent condition resulting in disordered contraction of the atria (top chambers of the heart). It affects one in four individuals during their lifetime. It is known that the arrhythmia has a bidirectional relationship with dysfunctional atrial contraction, a condition which itself is becoming understood as a means by which individuals may develop heart failure. However, the majority of published literature to date involves examining atrial function while lying supine at rest, thus incompletely characterizing the varying states of exertion that one experiences during activities of daily living. Exercise-based cardiovascular magnetic resonance imaging is a powerful non-invasive diagnostic modality that can measure heart function during exercise and has the potential to uncover key mechanisms by which patients with atrial fibrillation may progress to overt heart failure – and whether current treatment techniques (namely, catheter ablation) may alter that trajectory. The broad goal of this application is to facilitate training of the principal investigator, Dr. Cory Trankle, MD, for a career as a patient-centered independent researcher who uses exercise-based diagnostic modalities (including magnetic resonance imaging), with a specific interest in characterizing mechanisms of exercise limitations such as left atrial dysfunction and identifying them as potential biomarkers and targets for therapeutic interventions. In addition to didactic coursework and subspecialty seminars, Dr. Trankle will lead a multidisciplinary team conducting a prospective clinical study investigating the effects that catheter ablation for atrial fibrillation has on atrial function during exercise. He will address three specific aims in patients with atrial fibrillation undergoing catheter ablation: (1) determine the effects of ablation on the ability of the left atrium to augment its function during exercise, (2) determine the impacts ablation on left ventricular performance during exercise, and (3) determine whether those changes experienced in left ventricular performance are indeed associated with changes in left atrial function. A better understanding of the impact of catheter ablation, a common treatment for atrial fibrillation, has on these cardiac structures during exercise has the potential to identify those at highest risk for heart failure incidence and lead to more targeted treatment in this highly prevalent disease.

项目概要 心房颤动是一种非常普遍的疾病，导致心房收缩紊乱（心房的顶部心室） 众所周知，心律失常会影响四分之一的人的一生。 与功能失调的心房收缩的双向关系，这种情况本身正在逐渐被理解 作为个人可能发展心力衰竭的一种手段，然而，大多数已发表的文献都认为。 日期涉及在仰卧休息时检查心房功能，因此不能完全表征不同的心房功能 日常生活活动中所经历的劳累状态 基于运动的心血管磁力。 共振成像是一种强大的非侵入性诊断方式，可以测量心脏功能 锻炼并有可能揭示房颤患者可能的关键机制 进展为明显的心力衰竭——以及当前的治疗技术（即导管消融）是否可能 改变该轨迹。 此应用程序的总体目标是促进首席研究员 Cory Trankle 博士（医学博士）的培训 作为以患者为中心的独立研究人员，他使用基于运动的诊断方式（包括 磁共振成像），特别关注运动限制的机制特征 例如左心房功能障碍并将其识别为潜在的生物标志物和治疗靶标 除了教学课程和专业研讨会之外，Trankle 博士还将领导一个小组。 多学科团队进行了一项前瞻性临床研究，调查导管消融治疗的影响 他将针对心房颤动患者提出三个具体目标。 接受导管消融的颤动：（1）确定消融对左心房收缩能力的影响 增强其在运动过程中的功能，（2）确定消融对运动过程中左心室性能的影响 锻炼，以及（3）确定左心室性能所经历的这些变化是否确实是 与左心房功能变化相关的更好地了解导管消融的影响，a 房颤的常见治疗方法，在运动期间对这些心脏结构有潜力 识别那些心力衰竭发病风险最高的人，并在这种高度集中的情况下进行更有针对性的治疗 流行疾病。