4D Flow MRI-based assessment of atrial fibrillation

基于 4D Flow MRI 的心房颤动评估

• 批准号: 9566839
• 负责人: Liliana Ma
• 金额: $ 3.9万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2021-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9566839
• 关键词: 4D MRI; Ablation; Acceleration; Accounting; Adult; Affect; American; Anti-Arrhythmia Agents; Anticoagulation; Arrhythmia; Atrial Fibrillation; Blood; Blood flow; Brain; Breathing; Cardiac; Cardiovascular system; Characteristics; Clinical Research; Data; Development; Diagnostic; Diagnostic Procedure; EFRAC; Epidemiology; Equilibrium; Feasibility Studies; Geometry; Goals; Heart; Heart Atrium; Hemorrhage; Image; Imagery; Individual; Interobserver Variability; Ischemic Stroke; Lead; Left; Left atrial structure; Length; Longitudinal Studies; MRI Scans; Magnetic Resonance Imaging; Maps; Measures; Methods; Monitor; Myocardial tissue; Patients; Pattern; Peripheral; Pharmacotherapy; Predictive Value; Prevention; Prevention strategy; Property; Protocols documentation; Reproducibility; Resolution; Risk; Risk Assessment; Risk Factors; Scanning; Shapes; Sinus; Stroke; Stroke prevention; System; Techniques; Technology; Testing; Thromboembolism; Thrombus; Time; Tissues; Travel; United States; Variant; Warfarin; auricular appendage; base; clinical application; cohort; cost; healthy volunteer; hemodynamics; high risk; improved; in vivo; method development; noninvasive diagnosis; personalized strategies; prevent; protocol development; residence; spatiotemporal; stroke risk

Project Summary/abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia and estimated to account for approximately 15% of all strokes in the United States. Studies have shown that strokes in these patients seem to be caused by peripheral thromboembolisms which form in the left atrial appendage and travel to the brain. Anticoagulation has been shown to be highly effective at preventing thromboembolism formation, but is associated with greater monitoring costs and bleeding risks. Clinicians lack non-invasive diagnostic techniques that can reliably assess atrial hemodynamics, and current stroke prevention management relies on empirically determined risk scores that have been shown to have low predictive value. 4D flow magnetic resonance imaging provides time-resolved, three directional velocity encoding, but is currently limited by long scan times and inadequate resolution. In addition, the beat-to-beat variation of AF has not been considered in current MRI protocols that collect data over multiple cardiac cycles. This project aims to develop a 4D flow MRI protocol that incorporates improved temporal-spatial resolution, decreased scan time, and real-time MRI to more comprehensively assess atrial hemodynamics in AF patients. We will develop this protocol, assess repeatability and accuracy, and apply the protocol to a small study of AF patients and healthy volunteers.

项目摘要/摘要： 心房颤动（AF）是最常见的心律不齐，估计要考虑 在美国所有中风中约有15％。研究表明，这些患者的中风似乎 是由外周血栓栓塞引起的，这些血栓栓塞在左心房附属物中形成并传播到大脑。 抗凝治疗已被证明在防止血栓栓塞形成方面非常有效，但是 与更大的监控成本和出血风险相关。临床医生缺乏无创诊断技术 这可以可靠地评估心房血液动力学，并且当前的预防中风管理依赖于经验 确定的风险评分已显示为低预测值。 4D流磁共振 成像提供时间分辨，三个定向速度编码，但目前受到长时间扫描时间的限制 和分辨率不足。此外，在当前MRI中尚未考虑AF的Beat-Beat变化 通过多个心脏周期收集数据的协议。该项目旨在制定4D流MRI协议 其中包括改进的时间空间分辨率，减少扫描时间和实时MRI到更多 全面评估AF患者的心房血液动力学。我们将制定此协议，评估 可重复性和准确性，并将方案应用于对AF患者和健康志愿者的小型研究。