PET/MRI imaging of mitral valve prolapse
二尖瓣脱垂的 PET/MRI 成像
基本信息
- 批准号:10747508
- 负责人:
- 金额:$ 204.32万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-08-25 至 2028-06-30
- 项目状态:未结题
- 来源:
- 关键词:AddressAffectAffinityArrhythmiaBiological MarkersBiopsy SpecimenBloodCardiacCd68CharacteristicsChronicCicatrixClinicalClinical ManagementClinical ResearchCollectionComplexCross-Sectional StudiesDataDetectionDevelopmentDiseaseDisease-Free SurvivalEchocardiographyEnrollmentEvaluationEventFibroblastsFibrosisFunctional disorderFutureGadoliniumGeneral PopulationGoalsGuidelinesHeart AtriumHeart failureHistologicHistologyHomeHybridsImageIncidenceInflammationInflammatoryInvestigationLeftLeft Ventricular DysfunctionLeft Ventricular Ejection FractionLocationMacrophageMagnetic Resonance ImagingMalignant - descriptorMeasuresMechanical StressMedicalMedical RecordsMitral ValveMitral Valve InsufficiencyMitral Valve ProlapseModalityMonitorMorphologyMyocardialMyocardiumMyofibroblastOperative Surgical ProceduresPTPRC genePatientsPatternPhasePhenotypePopulation CharacteristicsPositron-Emission TomographyPrevalenceProcessRecommendationRecording of previous eventsRiskRisk ReductionRoleSeriesSerumSeveritiesSignal TransductionStratificationStrokeTestingTherapeuticTimeTracerTractionVentricularVentricular ArrhythmiaVentricular Tachycardiacardiac magnetic resonance imagingcirculating biomarkerscohortcoronary fibrosisfluorodeoxyglucosefluorodeoxyglucose positron emission tomographyfollow-upglucose metabolismheart functionhigh riskimage guidedimprovedinflammatory markerlongitudinal analysismortality riskmyocardial injurynovelnovel strategiesoutcome predictionpapillary muscleprimary endpointrisk stratificationsecondary analysissecondary endpointstudy characteristicssudden cardiac deathuptake
项目摘要
PROJECT SUMMARY
Mitral valve prolapse (MVP), identified in 1-3% of the general population, is the most common cardiac valvular
abnormality, with complications that include heart failure, ventricular arrhythmias and sudden cardiac death
(SCD). It has been estimated that the incidence of MVP-related SCD is 0.14% to 1.5% per year, depending on
the clinical characteristics of the population studied. While there have been multiple features identified as
markers of increased risk, left ventricular replacement fibrosis appears to be a consistent finding in Arrhythmic
MVP. Late gadolinium enhancement (LGE) by cardiac magnetic resonance imaging (MRI) is considered the
most sensitive and specific modality for assessing the presence and distribution of replacement fibrosis and it
has been strongly associated with increased incidence of arrhythmic events in patients with MVP. Preliminary
investigations from our group suggest that these fibrotic changes may be preceded by a chronic inflammatory
phase and that inflammation and scarring may be part of a continuum of ventricular transformation and directly
associated with arrhythmia development and complexity. We now propose an in-depth characterization of the
relationship between intensity and pattern of 18F-fluorodeoxyglucose (FDG) uptake on hybrid Positron Emission
Tomography (PET)/MRI, arrhythmia burden, severity of MVP and mitral regurgitation (MR). Detailed data
including patients’ baseline characteristics, echocardiographic features, histological and biomarker data,
arrhythmic burden and characterization will be obtained in patients with MVP, mild, moderate and severe MR, in
order to establish the correlation between the disease process in its various stages and the PET/MRI phenotype.
Specifically, in Aim 1 we will establish the inflammatory origin of the 18F-FDG signature in a cohort of patients
with MVP, severe MR and class I/II indications for mitral valve surgery. Histology and serum for biomarker
analysis will be collected at the time of surgery. Patients will additionally undergo a second imaging session with
a novel PET tracer, 68Ga-DOTATATE, more specific for inflammation. In Aim 2, patients with MVP, mild or
moderate MR, and a history of ventricular ectopy, who do not have an indication for surgery, will be enrolled into
a longitudinal observational clinical study. We will perform 18F-FDG PET/MRI imaging, echocardiography, 7-day
event monitoring (PVC burden and complexity) as well as collect circulating biomarkers at baseline and at follow-
up after 24 months. Lastly, in Aim 3, we will assess the impact of MV surgery on myocardial inflammation and
function, by repeating the same assessment as in Aim 2 but 12 months post-surgery to explore associations
between MV surgery and changes in myocardial inflammation. With this comprehensive approach, our ultimate
goal is the creation of a novel platform for the assessment of MVP, particularly as it relates to risk stratification
of ventricular arrhythmias and SCD. We posit that the results of our studies may lead to more accurate imaging-
guided patient management and have the potential to significantly influence current guideline recommendations
for risk stratification assessment, medical therapy, and timing for surgical intervention.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
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David H Adams其他文献
Self-assessment questions: The hepato-enteric immune axis in health and disease
- DOI:
10.7861/clinmedicine.12-6-s79 - 发表时间:
2012-12-01 - 期刊:
- 影响因子:
- 作者:
Palak J Trivedi;David H Adams - 通讯作者:
David H Adams
David H Adams的其他文献
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