Development of MR-derived parameters of LV diastolic function: Validation and Comparison to LV and LA fibrosis

项目摘要 这一建议的临床影响是发展心脏MR方法来评价舒张功能 并确定它与左心室和左心房纤维化的关系。我们将测试的假设是，前- 现有的心室和心房纤维化（弥漫性纤维化）可能反映在心房压力增加或其他方面 心腔顺应性的舒张参数，这可以使用这些新的方法进行评估。我们也 假设舒张期参数和LV及LA弥漫性纤维化是独立重要预测因子 有大量证据表明，心房纤维化、EF保留的心力衰竭和新发AF可能与房颤有关。 AF发作是一个星座，彼此之间以及与舒张功能障碍密切相关。的 用于测量舒张功能的工具的开发将对患者护理产生巨大的影响。 本提案的目标是开发一种方法，用于容易地处理电影图像，以产生e '， 二尖瓣组织区域的舒张早期速度，使用特征跟踪方法。此外，目标 旨在开发和测试简单而可靠的二尖瓣血流E和A测量方法 瓣膜，并开发用于测量肺静脉流入的方法。验证将健康进行 受试者和110名患者。将包括重现性。 这项拨款的创新之处在于认识到舒张功能是至关重要的， 最近开发的测量左心室弥漫性纤维化和MRI的能力， 容量、应变和纤维化--了解心房收缩期和左心室收缩期心房压力之间的关系 心房重构我们进一步提出了创新的MR方法，包括黑血电影方法， 生成电影图像以更清楚地可视化瓣膜，并且可能具有进一步的应用。我们提出 使用具有相位对比的切片跟踪，这已经建立，但将联合收割机与特征结合， 跟踪以大大提高其临床可行性。 我们组建了一个团队，其中包括一名在新收购方面具有专业知识的MRI物理学家， 重建，非侵入性心脏病学家和放射科医生谁将指导翻译研究，和一个多- 模态心脏病专家，是疾病动物模型方面的专家，用于将舒张压的MR测量结果 功能与侵入性压力测量。PI是左心房评估领域的先驱， 其中舒张功能是主要影响。共同努力，实现这些目标，我们将开发一个新的 评估舒张功能参数E、A、e'等的方法，并定义它们在 心房颤动的发展。

Project Summary The clinical impact of this proposal is the development of cardiac MR methods for evaluating diastolic function and determining how it relates to left ventricular and left atrial fibrosis. We will test the hypothesis is that pre- existing ventricular and atrial fibrosis (diffuse fibrosis) may be reflected in increased atrial pressures, or in other diastolic parameters of chamber compliance, which can be evaluated using these new methods. We also hypothesize that diastolic parameters and LV and LA diffuse fibrosis will be independent important predictors of new onset AF. There is a wealth of evidence that atrial fibrosis, heart-failure with preserved EF, and new onset AF are a constellation all strongly associated with each other, and with diastolic dysfunction. The development of tools for measuring diastolic function will have enormous impact in patient care. The goals of this proposal are to develop a method for easily processing cine images to yield e', the early diastolic velocity of the mitral valvular tissue region, using feature tracking methods. Further, the goals are to develop and test methods for simple and robust E and A measurements of blood flow through the mitral valve, and to develop methods for measuring pulmonary vein inflow. The validations will proceed in healthy subjects and then 110 patients. The reproducibility will be included. The innovation of this grant is the recognition that diastolic function is critical-- in conjunction with the recently developed capabilities of measuring left ventricular diffuse fibrosis with and MRI, and left atrial volumes, strain, and fibrosis-- in understanding the relationship between atrial pressure during diastole and left atrial remodeling. We further propose innovative MR methods, including a black blood cine method, which will generate cine images to visualize the valves more clearly, and might have further applications. We propose the use of slice-following with phase-contrast, which is already established, but will combine it with feature- tracking to vastly improve its clinical feasibility. We have assembled a team including an MRI Physicists with expertise in novel acquisition and reconstruction, non-invasive cardiologists and a radiologist who will guide the translational studies, and a multi- modality cardiologist who is expert in animal models of disease, for correlating MR measurements of diastolic function with invasive pressure measurements. The PI is a pioneer in the area of left atrial evaluation, for which diastolic function is a major influence. Together, working on these Aims, we will develop a new approaches for evaluating diastolic functional parameters, E, A, e' and more, and define their role in development of atrial fibrillation.