MR Quantification of Myocardial Oxygen Utilization in Chronic Myocardial Infarction without Contrast

无对比慢性心肌梗塞心肌氧利用的 MR 定量

• 批准号: 10581563
• 负责人: Keigo Kawaji
• 金额: $ 16.61万
• 依托单位: ILLINOIS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10581563
• 关键词: Acute; Affect; American Heart Association; Anatomy; Angiography; Architecture; Biomechanics; Biomedical Engineering; Cardiac; Cardiomyopathies; Cardiovascular Diseases; Catheters; Cause of Death; Cessation of life; Chicago; Chronic; Clinical; Clinical Sciences; Contrast Media; Coronary; Coronary Arteriosclerosis; Coronary Artery Bypass; Data; Databases; Dedications; Detection; Development; Development Plans; Diagnosis; Discipline; Dissection; Echocardiography; Engineering; Evaluation; Exhibits; Functional disorder; Gadolinium; Goals; Heart; Heart Diseases; Image; Individual; Infarction; Injections; Injury; Institution; Ionizing radiation; Knowledge; Lead; MRI Scans; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Measurement; Measures; Medicine; Mentors; Methods; Modality; Motion; Myocardial; Myocardial Infarction; Myocardial Ischemia; Myocardial tissue; Myocardium; Outcome; Oxygen; Patient imaging; Patients; Pharmaceutical Preparations; Physicians; Physiologic pulse; Protocols documentation; Publishing; Reference Standards; Research; Research Design; Research Personnel; Risk; Roentgen Rays; Scanning; Stents; Stroke; Techniques; Testing; Thallium Myocardial Perfusion Imaging Stress Test; Time; Tissues; Training; United States; United States National Institutes of Health; Universities; Update; Validation; Vascularization; Ventricular Function; Work; brain magnetic resonance imaging; cardiac magnetic resonance imaging; career; career development; clinically significant; cohort; design; follow-up; heart imaging; image reconstruction; imaging approach; imaging modality; improved; magnetic resonance imaging biomarker; new technology; non-invasive imaging; novel; patient oriented; patient oriented research; percutaneous coronary intervention; pre-clinical; rapid detection; response; screening; technique development; technology development

PROJECT SUMMARY The overall goal of this research is to develop a quantitative Magnetic Resonance Imaging (MRI) approach of oxygen utilization that provides a non-invasive and effective imaging test for the assessment of myocardial infarction. According to the most recent Heart Disease and Stroke Statistical Update (2015) published by the American Heart Association, almost 1 out of every 3 deaths in the United States (US) is caused by cardiovascular diseases that include coronary artery disease (CAD) every year. Over $40 billion is spent on cardiac stress tests each year, and nearly 1.5 million individuals are undergo percutaneous coronary intervention or coronary artery bypass surgery to treat severe CAD after nuclear stress test screening. However, the occurrence of obstructive CAD found during invasive stenting/pre-surgical coronary X-ray angiography is less than 40%. The current screening paradigm is expensive, exposes patients to ionizing radiation, and carries additional risks of intimal injury and acute vessel dissection. Cardiac Magnetic Resonance Imaging is a non-invasive imaging modality that currently is the gold standard for the quantitative assessment of ventricular function and myocardial viability evaluation. In particular, LGE can assess viable or non-viable myocardial tissue by interrogating the delayed response to gadolinium-based contrast agent administration. While this LGE assessment is robust, this reference evaluation leaves no room for further improvements via scan-time reduction, and forces any further quantification of underlying tissue pathophysiology to be obtained as separate scans that prolong each patient exam. Accordingly, the 30-plus minute LGE-CMR exam with contrast injection is the widely established, and definitive state-of-art. The scientific premise for this research is that MRI of oxygen utilization provides correlative information on the extent of viable or non-viable tissue without contrast injection. We hypothesize that a non-contrast MR quantification of oxygen utilization in less than one minute of additional scan-time to current routine cardiac MR protocol may offer a new paradigm-shifting, fast alternative evaluation of myocardial infarctions without the need for contrast injection. Hence, we aim to: 1) develop the pulse sequence and advanced image reconstruction methods to quantify myocardial oxygen utilization; 2) validate this method in the patient cohort, and 3) evaluate the proposed cardiac MRI evaluation in a single-center patient imaging setting over a 3-year span in two subject cohorts. The outcome of this work is not only the scientific findings pertaining to the feasibility of the proposed MRI method, but also the compilation of an extensive 200-patient database including all quantitative study measurements of the state-of-the-art MRI evaluations, patient data including outcomes, as well as findings from other modalities such as x-ray catheter (and echo) if these are also performed.

项目总结 本研究的总体目标是开发一种定量磁共振成像(MRI)方法 氧利用为评估心肌梗死提供了一种无创和有效的成像测试 脑梗塞。根据最新发布的心脏病和中风统计更新(2015) 美国心脏协会，在美国，几乎每3例死亡中就有1例是由 心血管疾病，包括每年的冠状动脉疾病(CAD)。超过400亿美元被花费在 每年进行心脏负荷测试，近150万人接受经皮冠状动脉介入治疗 介入或冠状动脉旁路手术治疗核负荷试验筛查后的严重冠心病。 然而，在有创支架置入术/术前冠状动脉X光检查中发现梗阻性CAD的发生 血管造影术不到40%。目前的筛查模式成本高昂，使患者暴露于电离辐射 辐射，并增加了血管内膜损伤和急性血管夹层的风险。心脏磁化 磁共振成像是一种非侵入性的成像方式，目前是定量的黄金标准 心功能评估和心肌存活评估。 特别是，LGE可以通过询问延迟反应来评估存活或不存活的心肌组织 基于Gd的造影剂给药。虽然此LGE评估是可靠的，但此参考 评估没有留下任何通过减少扫描时间进行进一步改进的空间，并迫使 基础组织病理生理学的量化将作为延长每个患者的单独扫描获得 考试。因此，30分钟以上的对比剂注射LGE-CMR检查是广泛建立的，并且 绝对最先进的技术。 这项研究的科学前提是，氧气利用的磁共振成像提供了有关 未注射造影剂的活组织或不活组织的范围。我们假设一个非对比度的MR 对当前常规心脏额外扫描时间不到一分钟的氧气利用率的量化 MR方案可能提供一种新的范式转换、快速替代的心肌梗死评估方法 需要注射造影剂。 因此，我们的目标是：1)发展脉冲序列和先进的图像重建方法来量化 心肌氧利用率；2)在患者队列中验证该方法，以及3)评估建议的 在两个受试者队列的3年时间里，对单中心患者的心脏MRI成像环境进行评估。 这项工作的结果不仅是关于拟议核磁共振可行性的科学发现 方法，而且还汇编了一个广泛的200名患者的数据库，包括所有定量研究 测量最先进的MRI评估、包括结果在内的患者数据以及发现 其他方式，如X-射线导管(和回声)，如果这些也进行。

项目成果

Cell-Laden Gradient Hydrogel Scaffolds for Neovascularization of Engineered Tissues.

• DOI: 10.1002/adhm.202001706
• 发表时间: 2021-04
• 期刊: Advanced healthcare materials
• 影响因子: 10
• 作者: He YJ;Santana MF;Staneviciute A;Pimentel MB;Yang F;Goes J;Kawaji K;Vaicik MK;Abdulhadi R;Hibino N;Papavasiliou G
• 通讯作者: Papavasiliou G