Validation of Myocardial Oxygen Extraction Fraction Measurement with MRI

MRI 心肌氧提取分数测量的验证

• 批准号: 10735534
• 负责人: Pamela K Woodard
• 金额: $ 65.25万
• 依托单位: WASHINGTON 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 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10735534
• 关键词: Acetates; Affect; Animal Model; Area; Artificial Intelligence; Biological; Blood; Blood Volume; Blood flow; Canis familiaris; Cardiac; Cardiomyopathies; Cardiovascular system; Catheters; Cell Respiration; Clinical; Compensation; Consumption; Contrast Media; Coronary Arteriosclerosis; Coronary Stenosis; Coronary sinus structure; Coupled; Coupling; Data Analyses; Defect; Dependence; Detection; Development; Diagnosis; Dilated Cardiomyopathy; Drops; Early Diagnosis; Equation; Equilibrium; Evaluation; Exercise; Functional disorder; Heart; Heart Diseases; Heart Valve Diseases; Heart failure; Human Volunteers; Hyperemia; Hypertrophic Cardiomyopathy; Image; Imaging Techniques; Injury; Intervention; Intravenous; Ionizing radiation; Ischemia; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Measurement; Measures; Mechanics; Metabolic; Metabolic dysfunction; Metabolism; Methods; Monitor; Morphologic artifacts; Muscle Cells; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocardial perfusion; Myocardial tissue; Myocardium; Noise; Oxygen; Oxygen Consumption; Pathologic; Pathology; Patient Selection; Patients; Perfusion; Phase; Physiological; Positron-Emission Tomography; Pre-Clinical Model; Principal Investigator; Recovery of Function; Reperfusion Therapy; Residual state; Resolution; Rest; Sampling; Seminal; Signal Transduction; Stimulus; Structural defect; System; Techniques; Testing; Time; Tissues; Validation; Vasodilation; Ventricular; Water; Work; canine model; cardiac magnetic resonance imaging; cardioprotection; clinical application; cohort; cost; deep learning; deep learning model; detection method; fluorodeoxyglucose; fluorodeoxyglucose positron emission tomography; glucose uptake; healthy volunteer; imaging modality; improved; in vivo; ischemic cardiomyopathy; magnetic field; novel; novel therapeutic intervention; nuclear imaging; pharmacologic; pre-clinical; preservation; septic; tool; uptake; validation studies

Imbalance of myocardial oxygen supply and consumption precipitates a cascade of physiological changes resulting in ischemic pathology. While assessment of myocardial perfusion alone may allow accurate assessment of myocardial oxygen consumption in some pathophysiological conditions, the perfusion-oxygen consumption relationship is derailed in several conditions, including: myocardial ischemia and infarction, hypertrophic and dilated cardiomyopathies, heart failure, valvular heart disease, and septic cardiomyopathy. Importantly, this oxygen supply/perfusion mismatch occurs early – before mechanical dysfunction. Therefore, evaluation of myocardial consumption independent of perfusion is of importance for early diagnosis and monitoring of these pathophysiological conditions. Myocardial oxygen extraction fraction (mOEF), which relates the biologic coupling of myocardial blood flow (oxygen supply) to oxygen consumption, may provide a more accurate assessment of this balance. For example, in ischemic cardiomyopathy, adequate myocardial perfusion is commonly reduced by high grade epicardial coronary artery stenoses. To avoid ischemia-caused injury, mOEF is likely to be increased to compensate for decrease in myocardial perfusion and oxygen delivery to myocytes. Consequently, the affected myocardial regions drop into a so called “hibernating” state that is effective in the short term. In this respect, an accurate mOEF assessment is a unique tool, with the potential to determine the likelihood of cardiac functional recovery after reperfusion. To date, the reference method for non-invasive quantification of mOEF in vivo is Positron Emission Tomography (PET). We recently developed a novel contrast- free cardiovascular magnetic resonance (CMR) acquisition method to quantify mOEF in vivo that has several advantages over PET: our CMR method has better spatial resolution, shorter acquisition time, does not expose the patient to ionizing radiation, and could be more widely available than PET. The overall objective of this study is to leverage our expertise in CMR imaging to refine and rigorously validate this new mOEF method. In Aim 1. This technique will be developed with assistance of a novel deep learning approach for artifact-free images and then validated using large animal models with and without induced coronary artery disease. Invasive catheter-measured and non-invasive PET-MRI-measured mOEF will be used as reference. In Aim 2, the CMR mOEF method will be validated in a small cohort of patients with hibernating myocardium in vivo, with the availability of 18F-FDG-PET as reference. Although we will study this mOEF technique in hibernating myocardium, this imaging method can be applied to the diagnosis and evaluation of treatments in a wide range of cardiomyopathies. Given the capability of CMR for the comprehensive assessment of myocardial function, tissue characterization, and viability, successful completion of CMR mOEF validation will provide a ‘one-stop shop’ evaluation of metabolic, functional, and structural abnormalities in patients with cardiomyopathy. Furthermore, the advantage of fast imaging without using an intravenous contrast agent is well-suited for repeat quantitative mOEF measurements needed to guide the effects of novel therapeutic interventional strategies.

心肌氧供需失衡引发一系列生理变化 导致了缺血病理。而仅对心肌灌注的评估可能会使 心肌耗氧量在某些病理生理条件下的评价 消费关系在几种情况下脱轨，包括：心肌缺血和梗塞， 肥厚性和扩张性心肌病、心力衰竭、瓣膜心脏病和感染性心肌病。 重要的是，这种供氧/灌流不匹配的情况很早就发生了--在机械功能障碍之前。因此， 独立于心肌灌注量的心肌消耗评估对早期诊断和 对这些病理生理状况的监测。心肌氧摄取分数(MOEF)，这与 心肌血流量(供氧)与耗氧量的生物耦合，可能提供更多的 对这种平衡的准确评估。例如，在缺血性心肌病中，充足的心肌灌注 通常由高级别的心外膜冠状动脉狭窄减少。为避免缺血造成的损伤，MOEF 可能会增加，以补偿心肌灌注和向心肌细胞输送氧气的减少。 因此，受影响的心肌区域进入所谓的“冬眠”状态，这种状态在 短期的。在这方面，准确的经济部评估是一个独特的工具，有可能确定 再灌注后心功能恢复的可能性。到目前为止，无创治疗的参考方法 体内MOEF的定量是正电子发射断层扫描(PET)。我们最近开发了一种新的对比度- 游离心血管磁共振(CMR)采集方法在体内定量MOEF中的应用 与PET相比，我们的CMR方法具有更好的空间分辨率，更短的采集时间，不曝光 患者对电离辐射的耐受性，可以比PET更广泛地获得。这样做的总体目标是 研究的目的是利用我们在CMR成像方面的专业知识来改进和严格验证这一新的MOEF方法。在……里面 目标1.这项技术将在一种新的深度学习方法的帮助下开发，以实现无伪影 图像，然后使用有和没有诱发冠状动脉疾病的大型动物模型进行验证。侵入性 导管测量和无创性PET-MRI测量的MOEF将作为参考。在Aim 2中，CMR MOEF方法将在体内冬眠心肌患者的一小部分队列中得到验证， 18F-FDG-PET的可用性作为参考。虽然我们将在冬眠心肌中研究这种MOEF技术， 这种成像方法可广泛应用于诊断和评价治疗方法。 心肌病。鉴于CMR对心肌功能的综合评估能力，组织 成功完成CMR MOEF验证的表征和可行性将提供一站式服务 评价心肌病患者的代谢、功能和结构异常。此外， 不使用静脉造影剂的快速成像的优势非常适合重复定量 需要MOEF测量来指导新的治疗干预策略的效果。