Detection of Left Ventricular Dyssynchrony by Cross-Correlation Analysis

通过互相关分析检测左心室不同步

• 批准号: 7820899
• 负责人: JOHN N OSHINSKI
• 金额: $ 2.79万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2010-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7820899
• 关键词: Acute; Admission activity; Artificial cardiac pacemaker; Cardiac; Cardiac Output; Clinical; Data; Data Set; Databases; Detection; Diagnosis; Diastole; EFRAC; EKG QRS Complex; Electrocardiogram; Heart; Heart failure; Hospitals; Image; Lead; Left; Measures; Mechanics; Methodology; Methods; Mitral Valve Insufficiency; Multi-Institutional Clinical Trial; Myocardial Contraction; Myocardial tissue; Myocardium; Outcome; Pacemakers; Patient Selection; Patients; Performance; Pharmaceutical Preparations; Publishing; Receiver Operating Characteristics; Refractory; Relaxation; Reporting; Research Personnel; Sensitivity and Specificity; Severities; Surface; Testing; Time; Tissues; United States; Ventricular; Ventricular Function; Ventricular Remodeling; base; computerized data processing; hemodynamics; implantation; improved; inclusion criteria; normal aging; novel; response; tool

Project Summary In thirty percent of patients with severe, drug-refractory heart failure, regional timing of myocardial contraction and relaxation is dyssynchronous. This mechanical dyssynchrony leads to adverse ventricular remodelling, increased mitral regurgitation, and reduced ejection fraction. Cardiac resynchronization therapy (CRT) is a relatively new treatment for heart failure patients with dyssynchrony that results in both acute hemodynamic benefit as well as improved long-term outcome. Despite CRT showing benefits in many multi- center clinical trials, 30% of patients selected for CRT show no improvement by clinical or echocardiographic endpoints. This poor response rate may in part be explained by limitations of current methods to determine the presence and severity of dyssynchrony. To overcome the limitations of existing dyssynchrony parameters, we have developed a new mathematical method to calculate a temporal delay between two myocardial tissue velocity profiles acquired with tissue Doppler imaging (TDI). Our method utilizes a function to quantify either systolic, diastolic, or whole- cycle delays using TDI data collected throughout the cardiac cycle. The objectives of this study are to evaluate the ability of our method to: 1) quantify mechanical dyssynchrony in the heart, and 2) predict response to CRT. Preliminary data in a group of young, healthy, normal subjects (negative controls) and known responders to CRT (positive controls) indicate excellent sensitivity and specificity of the methodology. The central hypothesis of this study is that our method of determining dyssynchrony delays is more sensitive and specific in selecting patients who respond to CRT compared to currently utilized methods. To test the hypothesis, we will utilize an existing data set of from a large, multi-center CRT trial (PROSPECT trial). The specific aims of this project are: 1) Quantify systolic, diastolic and whole-cycle delays in a group on normal, aged-matched subjects (negative controls) and compare delay values in these subjects to delay values in a group known responders to CRT (positive controls). 2) Evaluate the ability of systolic, diastolic, and whole-cycle delays to predict response to CRT using an existing large, multi-center database of 260 patients. Project Narrative We propose to develop and test a new method to improve selection of patients who will benefit from cardiac pacemaker implantation. The methodology uses signal processing methods based on echocardiographic image data. We will use images from an existing database of 260 subjects. The method would improve patient selection so only subjects who would benefit from pacemaker implantation would be identified, and all subjects who would benefit from a pacemaker would be identified.

项目摘要 在30%的严重的药物难治性心力衰竭患者中， 收缩和舒张是不同步的。这种机械不同步导致不利的心室 重构、二尖瓣返流增加和射血分数降低。心脏再同步治疗 (CRT)是一种相对较新的治疗心力衰竭患者的不同步，导致急性 血流动力学益处以及改善的长期结果。尽管CRT在许多多方面显示出优势， 中心的临床试验中，30%的选择CRT的患者通过临床或超声心动图显示无改善 端点。这种低应答率的部分原因可能是目前确定药物敏感性的方法存在局限性。 不同步的存在和严重程度。 为了克服现有不同步参数的局限性，我们开发了一种新的 一种数学方法，用于计算所采集的两个心肌组织速度分布之间的时间延迟 组织多普勒成像（TDI）我们的方法利用一个函数来量化收缩期、舒张期或整体- 使用在整个心动周期中收集的TDI数据的周期延迟。本研究的目的是评估 我们的方法能够：1）量化心脏中的机械不同步，2）预测对CRT的反应。 一组年轻、健康、正常受试者（阴性对照）和已知的 CRT（阳性对照）表明该方法具有良好的灵敏度和特异性。核心假设 这项研究的一个重要方面是，我们确定不同步延迟的方法在选择 与目前使用的方法相比，对CRT有反应的患者。为了验证这个假设，我们将使用一个 来自大型多中心CRT试验（前景试验）的现有数据集。该项目的具体目标是： 1)量化正常、年龄匹配受试者的收缩期、舒张期和全周期延迟 （阴性对照），并将这些受试者的延迟值与已知的组中的延迟值进行比较。 CRT反应者（阳性对照）。 2)评价收缩期、舒张期和全周期延迟预测CRT反应的能力， 现有260名患者的大型多中心数据库。项目叙述 我们建议开发和测试一种新的方法，以改善选择患者谁将受益于心脏 起搏器植入该方法使用基于超声心动图的信号处理方法， 图像数据。我们将使用现有的260个主题的数据库中的图像。该方法将改善 患者选择，因此仅识别将从起搏器植入术中受益的受试者， 将确定将从起搏器受益的受试者。

项目成果

Cardiovascular magnetic resonance at 3.0 T: current state of the art.

• DOI: 10.1186/1532-429x-12-55
• 发表时间: 2010-10-07
• 期刊: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
• 作者: Oshinski JN;Delfino JG;Sharma P;Gharib AM;Pettigrew RI
• 通讯作者: Pettigrew RI

Time-resolved analysis of coronary vein motion and cross-sectional area.

• DOI: 10.1002/jmri.22674
• 发表时间: 2011-10
• 期刊: JOURNAL OF MAGNETIC RESONANCE IMAGING
• 影响因子: 4.4
• 作者: Suever, Jonathan D.;Watson, Pierre J.;Eisner, Robert L.;Lerakis, Stamatios;O'Donnell, Robert E.;Oshinski, John N.
• 通讯作者: Oshinski, John N.

It's time for a paradigm shift in the quantitative evaluation of left ventricular dyssynchrony.

现在是左心室不同步定量评估范式转变的时候了。

• DOI: 10.1016/j.echo.2009.04.012
• 发表时间: 2009
• 期刊: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
• 作者: Fornwalt,BrandonK;Delfino,JanaG;Sprague,WilliamW;Oshinski,JohnN
• 通讯作者: Oshinski,JohnN