Defining 4D Ventricular Mechanics in Acquired and Congenital Heart Disease

定义获得性心脏病和先天性心脏病的 4D 心室力学

• 批准号: 7866839
• 负责人: David J. Sahn
• 金额: $ 43.63万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-15 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7866839
• 关键词: Adoption; Adult; Algorithms; Arts; Cardiac; Cardiology; Chest; Clinical; Complex; Coupled; Dependency; Development; Diagnostic Imaging; Dimensions; Echocardiography; Evolution; Family suidae; Gold; Heart; Heart Diseases; Heart failure; Image; Imaging technology; Incentives; Left; Left ventricular structure; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Measurement; Mechanics; Methods; Motion; Myocardial; Myocardium; Painless; Pathologic; Patients; Phase; Prevalence; Property; Pulmonary Heart Disease; Pulmonary Hypertension; Pump; Radial; Research; Right Ventricular Function; Right ventricular structure; Rotation; Structure-Activity Relationship; System; Systole; Techniques; Technology; Testing; Therapeutic; Three-Dimensional Echocardiography; Time; Tissues; Translating; Ultrasonography; Validation; Ventricular; Ventricular Dysfunction; congenital heart disorder; heart function; heart imaging; heart motion; human subject; improved; interest; novel strategies; public health relevance; tool; two-dimensional

DESCRIPTION (provided by applicant): The rapid adoption of aggressive treatments for heart failure, including resynchronization pacing, has renewed interest in the fundamental electromechanical properties of the left ventricle. Related to MRI, this has resulted in research efforts aimed at the development and application of methods to assess left ventricular mechanics, including magnetic resonance tissue tagging, phase velocity myocardial mapping and cine DENSE displacement mapping in 3D space. By comparison, there have been fewer efforts to study right ventricular mechanics, even though in certain conditions such as congenital heart diseases, pulmonary hypertension and cor pulmonale, RV function can be more important than LV function. In echocardiography, the development of tissue Doppler strain rate methods have been by now followed by newer speckle tracking methods capable of showing multiple types of strain deformation without angle dependency, including circumferential shortening strain, radial thickening strain in systole and twisting and untwisting. Two-dimensional methods can define, to some extent, segmental motion in cross-sectional views, but are compounded by through-plane motion. For both echo and MRI, it will likely require a robust 3D method to comprehensively define regional ventricular wall motion and deformation. This proposal is aimed at development and validation of a method to obtain spatially-dense displacement fields of both left and right ventricular deformation maps from ultrasound scans performed on an advanced 3D echocardiographic system; a method that should be capable of showing strain displacement fields and torsional deformation for both ventricles. This proposal is aimed at further developing the techniques we have pioneered and validating them in a unique dynamic cardiac phantom and in open-chest pigs using sonomicrometry as a gold standard. We will also evaluate the efficacy of our new approach and translate it to the clinical setting by studying patients with congenital heart disease and compare our results from our method MRI tagging, and wall velocity encoded strain measurements. PUBLIC HEALTH RELEVANCE: Much interest exists in Cardiology in the recently developed 4D ultrasound technologies for imaging the heart. We believe that as informative as these dynamic qualitative anatomical diagnostic images are, the quantitative aspects of these 4D methods for defining cardiac mechanics are likely more important. The spatially-dense 4D speckle tracking method which we have developed and hope to further refine and test in this proposal could provide a method for study of the dynamic biventricular function of the heart, which could, in turn, improve therapeutic approaches to treatment of heart disease.

描述（由申请人提供）：包括重新同步起搏在内的心力衰竭积极治疗方法的迅速采用，重新引起了人们对左心室基本机电特性的兴趣。与 MRI 相关，这导致了旨在开发和应用评估左心室力学的方法的研究工作，包括磁共振组织标记、相速度心肌绘图和 3D 空间中的电影 DENSE 位移绘图。相比之下，研究右心室力学的努力较少，尽管在先天性心脏病、肺动脉高压和肺心病等某些情况下，右心室功能可能比左心室功能更重要。 在超声心动图中，随着组织多普勒应变率方法的发展，现在已经出现了更新的散斑跟踪方法，能够显示多种类型的应变变形而不依赖于角度，包括周向缩短应变、收缩期径向增厚应变以及扭曲和解扭曲。二维方法可以在某种程度上定义横截面视图中的分段运动，但会受到平面运动的复合。对于回波和 MRI，可能需要强大的 3D 方法来全面定义局部心室壁运动和变形。 该提案旨在开发和验证一种方法，从先进的 3D 超声心动图系统上进行的超声扫描中获取左心室和右心室变形图的空间密集位移场；一种应该能够显示两个心室的应变位移场和扭转变形的方法。该提案旨在进一步发展我们首创的技术，并在独特的动态心脏模型和开胸猪中使用声测法作为金标准验证它们。我们还将通过研究先天性心脏病患者来评估新方法的功效，并将其转化为临床环境，并比较我们的方法 MRI 标记和壁速度编码应变测量的结果。 公众健康相关性：心脏病学界对最近开发的用于心脏成像的 4D 超声技术非常感兴趣。我们相信，尽管这些动态定性解剖诊断图像信息丰富，但这些用于定义心脏力学的 4D 方法的定量方面可能更重要。我们开发并希望在本提案中进一步完善和测试的空间密集 4D 散斑跟踪方法可以为研究心脏的动态双心室功能提供一种方法，从而改善心脏病的治疗方法。