Using 5D flow MRI to decode the effects of rhythm on left atrial 3D flow dynamics in patients with atrial fibrillation.
Using 5D flow MRI to decode the effects of rhythm on left atrial 3D flow dynamics in patients with atrial fibrillation.
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使用5D flow MRI解码心律对房颤患者左心房3D血流动力学的影响。
DOI：
10.1002/mrm.28642
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发表时间：
2021-06
影响因子：
3.3
通讯作者：
Markl M
中科院分区：
文献类型：
--
作者：
Ma L;Yerly J;Di Sopra L;Piccini D;Lee J;DiCarlo A;Passman R;Greenland P;Kim D;Stuber M;Markl M
本研究采用5D血流框架探讨心律失常对心房颤动（AF）患者血栓形成血流动力学参数的影响。采用体外心律失常血流模体和25例有AF病史（68±8y, 6F）的患者，获得了一个完全自门控、三维径向、高加速自由运行的5D血流序列，该序列具有交错的4点速度编码。使用自门控信号计算AF负担、bin数据，并用其RRLength标记每条k空间线。数据作为一个具有4个rr间隔箱（RR1-RR4，从短到长）的rr分解数据集进行分类，用于压缩感知重建。房颤负荷计算方法为所有房内心率间隔的四分位数范围除以中位心率间隔，左房停滞（LA）为心跳周期中速度<0.1 m/s的百分比。体外结果表明，与实时PC参考标准品相比，使用rr -分辨5D流可成功恢复RR-binned流动曲线。在体内，5D血流在8:48分钟获得。房颤负荷与5D流源峰值（PV）和平均（MV）速度和停滞显著相关（∣ρ∣=0.54-0.75,p<0.001）。敏感性分析确定低与高心房颤动负担的阈值为9.7%。高负荷患者LA平均停滞增加（高达+42%，p<0.01）， MV和PV降低（分别为- 30%，- 40.6%,p<0.01）。RR4与呼吸分解重建（终末呼气）偏差最大，平均停滞增加（7.6%±14.0%,p=0.10）， PV降低（- 12.7±14.2%,p=0.09）。rr分辨5D血流可以在<10分钟内捕获时间和rr分辨3D血流动力学，为研究心律失常提供了一种新的方法。
This study used a 5D flow framework to explore the influence of arrhythmia on thrombogenic hemodynamic parameters in patients with atrial fibrillation (AF). A fully self-gated, 3D radial, highly-accelerated free-running 5D flow sequence with interleaved 4-point velocity-encoding was acquired using an in vitro arrhythmic flow phantom and in 25 patients with a history of AF (68±8y, 6F). Self-gating signals were used to calculate AF burden, bin data, and tag each k-space line with its RRLength. Data were binned as an RR-resolved dataset with 4 RR-interval bins (RR1-RR4, short-to-long) for compressed sensing reconstruction. AF burden was calculated as interquartile range of all intrascan RR-intervals divided by median RR-interval, and left atrial (LA) stasis as the percent of the cardiac cycle where the velocity was <0.1 m/s. In vitro results demonstrated successful recovery of RR-binned flow curves using RR-resolved 5D flow compared to a real-time PC reference standard. In vivo, 5D flow was acquired in 8:48 minutes. AF burden was significantly correlated with 5D flow-derived peak (PV) and mean (MV) velocity and stasis (∣ρ∣=0.54-0.75, p<0.001). Sensitivity analyses determined a threshold for low versus high AF burden at 9.7%. High burden patients had increased LA mean stasis (up to +42%, p<0.01), and lower MV and PV (−30%, −40.6%, respectively, p<0.01). RR4 deviated furthest from respiratory-resolved reconstruction (end-expiration) with increased mean stasis (7.6%±14.0%, p=0.10) and decreased PV (−12.7±14.2%, p=0.09). RR-resolved 5D flow can capture temporal and RR-resolved 3D hemodynamics in <10 minutes and offers a novel approach to investigate arrhythmias.
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影响因子：
3.3
作者：
Lin, Hung-Yu;Bender, Jacob A.;Ding, Yu;Chung, Yiu-Cho;Hinton, Alice M.;Pennell, Michael L.;Whitehead, Kevin K.;Raman, Subha V.;Simonetti, Orlando P.
通讯作者：
Simonetti, Orlando P.
影响因子：
3.3
作者：
Hammernik K;Klatzer T;Kobler E;Recht MP;Sodickson DK;Pock T;Knoll F
通讯作者：
Knoll F
影响因子：
3.3
作者：
Bastiaansen, Jessica A. M.;Piccini, Davide;Stuber, Matthias
通讯作者：
Stuber, Matthias
影响因子：
3.3
作者：
Di Sopra, Lorenzo;Piccini, Davide;Yerly, Jerome
通讯作者：
Yerly, Jerome
影响因子：
3.3
作者：
Bastkowski, Rene;Weiss, Kilian;Giese, Daniel
通讯作者：
Giese, Daniel