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Push-Button Cardiac MRI for Non-Invasive Quantification of Myocardial Energy Consumption in Heart Failure

按钮式心脏 MRI 用于心力衰竭心肌能量消耗的无创定量

基本信息

批准号：
10684051
负责人：
Hsin-Jung Yang
金额：
$ 78.49万
依托单位：
CEDARS-SINAI MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-15 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10684051
关键词：
Adopted Aerobic Affect Anatomy Animal Model Award Biological Markers Blood Blood flow Breathing Cardiac Cardiac health Catheterization Chronic Classification Clinical Contrast Media Coronary Arteriosclerosis Coronary Circulation Coronary sinus structure Cyclotrons Data Dependence Development Diastole Disease Disease Surveillance Dose Early Diagnosis Early Intervention Energy Metabolism Energy consumption Family suidae Flowmetry Foundations Functional disorder Guidelines Heart Heart Rate Heart failure Hospitalization Image Impairment Ionizing radiation Journals Magnetic Resonance Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Maps Measurement Measures Mechanics Mediation Medical Care Costs Mental Depression Methods Modeling Monitor Motion Movement Myocardial Myocardial Infarction Myocardial dysfunction Myocardium Needles Outcome Oxygen Oxygen Consumption Oxygen saturation measurement Patients Persons Phase Physiologic pulse Play Population Positron-Emission Tomography Preventive Preventive treatment Procedures Prognosis Publications Recommendation Research Personnel Resolution Rest Risk Role Secondary to Site Societies Staging Stress Systole Techniques Testing Time Treatment Efficacy Treatment Failure Venous Work blood oxygen level dependent cardiac magnetic resonance imaging career clinical practice efficacy evaluation heart function heart metabolism heart motion high risk imaging modality improved outcome mortality risk new epidemic novel novel therapeutic intervention novel therapeutics oxidation pharmacologic prevent respiratory screening targeted treatment therapy development tool

项目摘要

ABSTRACT Cardiac Energy consumption is the central determinant of cardiac function. Its impairment is the hallmark of heart failure (HF), which accounts for nearly $40 billion in medical costs every year and is the most frequent cause of hospitalization. In HF pathophysiology, the depression of contractile force of the myocardium is not matched by a concomitant depression of energy consumption. This results in the uncoupling between mechanical contraction and energy expenditure of the heart, which drives systolic or diastolic dysfunction of the heart. Thus, the detection of early alterations in cardiac energetics in HF patients can provide critical information on heart health and guide novel therapeutic interventions for HF which are under development. Since the heart relies almost exclusively on aerobic oxidation, the gold standard for staging alterations in cardiac energetics is from invasively measured whole heart myocardial oxygen consumption (MVO2). However, invasive catheterization is not a practical way for repeat surveillance of the disease in the suspect population or the monitoring of therapeutic efficacy. Hence there is an unmet need for a noninvasive approach that can enable repeatable quantitative assessment of cardiac energetics. Significant effort has been made towards developing noninvasive techniques for MVO2 measurement, particularly based on positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). However, they have not made it into the clinical arena due to major technical/practical limitations. An alternative approach, which overcomes key limitations of PET and longstanding technical challenges of MRS for estimating MVO2, employs magnetic resonance oximetry. Nonetheless, this requires simultaneous and reliable mapping of quantitative MR parameters in the rapidly moving coronary sinus, which is nearly impossible for the CMR techniques today. Here, we propose to develop and validate a single, fast, free-breathing, motion-insensitive acquisition to simultaneously derive coronary sinus oxygen saturation and myocardial blood flow for MVO2 measurement. We will test the developed method in detecting the impaired cardiac energy consumption level in an animal model with heart failure. The proposed method is expected to quantify cardiac energy consumption noninvasively, without ionizing radiation, and exogenous contrast agents. Accordingly, forming the foundation toward (1) early detection and classification of HF for target treatments, (2) prognosis of HF without invasive procedures, and (3) longitudinal monitoring of HF progression to guide the development of novel HF therapies.

摘要