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: 10538265
• 负责人: Justin J Baraboo
• 金额: $ 4.27万
• 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/10538265
• 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; Detection; Development; Dimensions; Ensure; Equilibrium; Evaluation; Funding; Future; Goals; Grant; Heart; Heart Atrium; Heart Rate; Hemorrhage; Image; Imaging Techniques; Impairment; In Vitro; Ischemic Stroke; Lead; 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; Scheme; Secondary to; Selection for Treatments; Signal Transduction; Sorting - Cell Movement; Source; Standardization; Stroke; Techniques; Testing; Thrombus; Time; Training; Translations; Triad Acrylic Resin; Validation; Variant; Wit; auricular appendage; base; 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; 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.

项目总结