RESUMO
Heart failure with preserved ejection fraction (HFpEF) is typically associated with early metabolic remodeling. Noninvasive imaging biomarkers that reflect these changes will be crucial in determining responses to early drug interventions in these patients. Mean intracellular water lifetime (τi ) has been shown to be partially inversely related to Na, K-ATPase transporter activity and may thus provide insight into the metabolic status in HFpEF patients. Here, we aim to perform regional quantification of τi using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) in the nonhuman primate (NHP) heart and evaluate its region-specific variations under conditions of myocardial stress in the context of perturbed myocardial function. Cardiac stress was induced in seven naïve cynomolgus macaques using a dobutamine stepwise infusion protocol. All animals underwent 3 T cardiac dual-bolus DCE and tagging MRI experiments. The shutter-speed model was employed to quantify regional τi from the DCE-MR images. Additionally, τi values were correlated with myocardial strains. During cardiac stress, there was a significant decrease in global τi (192.9 ± 76.3 ms vs 321.6 ± 70 ms at rest, P < 0.05) in the left ventricle, together with an increase in global peak circumferential strain (-15.4% ± 2.7% vs -10.1% ± 2.9% at rest, P < 0.05). Specifically, slice-level analysis further revealed that a greater significant decrease in mean τi was observed in the apical region (ΔτI = 182.4 ms) compared with the basal (Δτi = 113.2 ms) and midventricular regions (Δτi = 108.4 ms). Regional analysis revealed that there was a greater significant decrease in mean τi in the anterior (Δτi = 243.9 ms) and antero-lateral (Δτi = 177.2 ms) regions. In the inferior and infero-septal regions, although a decrease in τi was observed, it was not significant. Whole heart regional quantification of τi is feasible using DCE-MRI. τi is sensitive to regional changes in metabolic state during cardiac stress, and its value correlates with strain.
Assuntos
Miocárdio/patologia , Estresse Fisiológico , Água/química , Animais , Biomarcadores/metabolismo , Macaca fascicularis , Imageamento por Ressonância Magnética , Masculino , Fatores de TempoRESUMO
PURPOSE: To identify reproducible and reliable noninvasive regional imaging biomarkers of cardiac function and perfusion at rest and under stress in healthy nonhuman primates (NHPs) that may be used in the future for the early characterization of preclinical heart failure models, to evaluate therapy, and for clinical translation. MATERIALS AND METHODS: Seven naive cynomolgus macaques underwent test-retest 3T cardiac MRI tagging and dual-bolus perfusion experiments. Regional cardiac function biomarkers, such as peak circumferential strain (CS), average diastolic strain-rate (DSR), contractile reserve (CR), diastolic reserve, peak torsion, and torsion reserve were quantified. Further, regional myocardial blood flow (MBF), myocardial perfusion reserve (MPR), and myocardial perfusion reserve-to-contractile reserve (MPR/CR) were also derived. Inter- and intraobserver reproducibility and test-retest reliability analyses were conducted using the reliability and generalizability coefficients including correlation coefficient (CC) and intraclass correlation coefficient (ICC). RESULTS: Overall, peak CS, DSR, and MBF are robust biomarkers at both rest and stress with moderate-good inter- and intraobserver reproducibility and test-retest reliability. At rest: intra-/interobserver reproducibility (CC): peak CS (0.81/0.81), DSR (0.81/0.81), MBF (0.72/0.57), peak torsion (0.79/0.79); test-retest reliability: (CC/ICC): peak CS (0.62/0.75), DSR (0.24/0.55), MBF (0.66/0.62), and peak torsion (0.79/0.78). Under stress: intra-/interobserver reproducibility (CC): peak CS (0.61/0.60), DSR (0.50/0.50), MBF (0.63/0.61), MPR (0.43/0.43), and peak torsion (0.38/0.38); test-retest reliability: (CC/ICC): peak CS (0.58/0.58), DSR (0.24/0.43), MBF (0.58/0.58), MPR (0.43/0.38), and peak torsion (0.38/0.38). CONCLUSION: We demonstrated the feasibility of using cardiac MRI to characterize left ventricular functional and perfusion responses to stress in an NHP species, and specific robust biomarkers such as peak CS, DSR, MBF, diastolic reserve, and MPR have been identified for clinical translation and drug research. LEVEL OF EVIDENCE: 1 J. Magn. Reson. Imaging 2017;45:556-569.
Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Circulação Coronária/fisiologia , Dobutamina , Teste de Esforço/métodos , Ventrículos do Coração/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética/métodos , Função Ventricular Esquerda/fisiologia , Animais , Biomarcadores , Humanos , Macaca fascicularis , Angiografia por Ressonância Magnética/métodos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Noninvasive quantification of regional left ventricular rotation may improve understanding of cardiac function. Current methods used to quantify rotation typically acquire data on a set of prescribed short-axis slices, neglecting effects due to through-plane myocardial motion. We combine principles of slice-following tagged imaging with harmonic phase analysis methods to account for through-plane motion in regional rotation measurements. We compare rotation and torsion measurements obtained using our method to those obtained from imaging datasets acquired without slice-following. Our results in normal volunteers demonstrate differences in the general trends of average and regional rotation-time plots in midbasal slices and the rotation versus circumferential strain loops. We observe substantial errors in measured peak average rotation of the order of 58% for basal slices (due to change in the pattern of the curve), -6.6% for midventricular slices, and -8.5% for apical slices; and an average error in base-to-apex torsion of 19% when through-plane motion is not considered. This study concludes that due to an inherent base-to-apex gradient in rotation that exists in the left ventricular, accounting for through-plane motion is critical to the accuracy of left ventricular rotation quantification.
Assuntos
Algoritmos , Ventrículos do Coração/anatomia & histologia , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Imagem Cinética por Ressonância Magnética/métodos , Reconhecimento Automatizado de Padrão/métodos , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Reprodutibilidade dos Testes , Rotação , Sensibilidade e Especificidade , Adulto JovemRESUMO
A high-temporal resolution 2D flow pathline analysis method to study early diastolic filling is presented. Filling patterns in normal volunteers (n = 8) and canine animals [baseline (n = 1) and infarcted (n = 6)] are studied. Data are acquired using spatial modulation of magnetization with polarity alternating velocity encoding, which permits simultaneous quantification of 1D blood velocities (using phase contrast encoding) and myocardial strain (using spatial modulation of magnetization tagging and harmonic phase analysis) at high-temporal resolution of 14 ms within a single breath hold. Virtual emitter particles, released from the mitral valve plane every time frame during rapid filling, are tracked to depict the 2D pathlines on the imaged plane. The pathline regional distribution is compared with myocardial longitudinal strains and to regional pressure gradients. Quantitative analysis of net kinetic energy of pathlines is finally performed. Our results demonstrate a linear correlation (r(2) = 0.85) between pathline spatial distribution and myocardial strain. Peak net kinetic energy of 0.06 ± 0.01 mJ in normal volunteers, 0.043 mJ in baseline dog, 0.143 ± 0.03 mJ in infarcted dogs with nominal flow dysfunction, and 0.016 ± 0.007 mJ in infarcted dogs with severe flow dysfunction is observed. In conclusion, 2D pathline analysis provides a direct regional assessment of early diastolic filling patterns and is sensitive to abnormalities in early diastolic filling.
Assuntos
Infarto do Miocárdio/fisiopatologia , Função Ventricular Esquerda/fisiologia , Adulto , Animais , Diástole , Cães , Feminino , Voluntários Saudáveis , Ventrículos do Coração , Humanos , MasculinoRESUMO
Background: Both heart failure (HF) with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) can present a wide variety of cardiac morphologies consequent to cardiac remodeling. We sought to study if geometric changes to the heart during such remodeling will adversely affect the ejection fraction (EF) parameter's ability to serve as an indicator of heart function, and to identify the mechanism for it. Methods and Results: A numerical model that simulated the conversion of myocardial strain to stroke volume was developed from two porcine animal models of heart failure. Hypertrophic wall thickening was found to elevate EF, while left ventricle (LV) dilation was found to depress EF when myocardial strain was kept constant, causing EF to inaccurately represent the overall strain function. This was caused by EF being calculated using the endocardial boundary rather than the mid-wall layer. Radial displacement of the endocardial boundary resulted in endocardial strain deviating from the overall LV strain, and this deviation varied with LV geometric changes. This suggested that using the epi- or endo-boundaries to calculate functional parameters was not effective, and explained why EF could be adversely affected by geometric changes. Further, when EF was modified by calculating it at the mid-wall layer instead of at the endocardium, this shortcoming was resolved, and the mid-wall EF could differentiate between healthy and HFpEF subjects in our animal models, while the traditional EF could not. Conclusion: We presented the mechanism to explain why EF can no longer effectively indicate cardiac function during cardiac geometric changes relevant to HF remodeling, losing the ability to distinguish between hypertrophic diseased hearts from healthy hearts. Measuring EF at the mid-wall location rather than endocardium can avoid the shortcoming and better represent the cardiac strain function.
RESUMO
Imaging the left ventricular mechanical and hemodynamic response to the stress of exercise may offer early prognosis in select patients with cardiac disease. Here, we demonstrate the feasibility of obtaining simultaneous measurements of longitudinal strain and transvalvular blood velocity during supine bicycle exercise stress in a wide bore magnetic resonance scanner. Combining information from the two datasets, we observe that although the time to peak strain (33.28 ± 1.86 versus 25.7 ± 2.12 as % of R-R interval) and time to peak mitral inflow velocity (44.37 ± 5.21 versus 35.5 ± 4.19 as % of R-R interval) from R-wave of the QRS complex occurred earlier during stress, the time from peak strain to peak mitral inflow velocity was not statistically different (16.5 ± 3.23 versus 13.4 ± 3.06). Further, the percentage of longitudinal relaxation at peak mitral inflow velocity was higher during stress (63.5 ± 7.72 versus 84.32 ± 6.24). These results suggest that although diastole is shortened, early diastolic filling efficiency is augmented during exercise stress in normal volunteers in an effort to maintain stroke volume.
Assuntos
Técnicas de Imagem por Elasticidade/métodos , Teste de Esforço/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Esforço Físico/fisiologia , Processamento de Sinais Assistido por Computador , Função Ventricular Esquerda , Algoritmos , Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Módulo de Elasticidade/fisiologia , Feminino , Humanos , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/instrumentação , Masculino , Projetos Piloto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Decúbito DorsalRESUMO
A novel MR imaging technique, spatial modulation of magnetization with polarity alternating velocity encoding (SPAMM-PAV), is presented to simultaneously examine the left ventricular early diastolic temporal relationships between myocardial deformation and intra-cavity hemodynamics with a high temporal resolution of 14 ms. This approach is initially evaluated in a dynamic flow and tissue mimicking phantom. A comparison of regional longitudinal strains and intra-cavity pressure differences (integration of computed in-plane pressure gradients within a selected region) in relation to mitral valve inflow velocities is performed in eight normal volunteers. Our results demonstrate that apical regions have higher strain rates (0.145 ± 0.005 %/ms) during the acceleration period of rapid filling compared to mid-ventricular (0.114 ± 0.007 %/ms) and basal regions (0.088 ± 0.009 %/ms), and apical strain curves plateau at peak mitral inflow velocity. This pattern is reversed during the deceleration period, when the strain-rates in the basal regions are the highest (0.027 ± 0.003 %/ms) due to ongoing basal stretching. A positive base-to-apex gradient in peak pressure difference is observed during acceleration, followed by a negative base-to-apex gradient during deceleration. These studies shed insight into the regional volumetric and pressure difference changes in the left ventricle during early diastolic filling.
Assuntos
Técnicas de Imagem por Elasticidade/métodos , Ventrículos do Coração/anatomia & histologia , Interpretação de Imagem Assistida por Computador/métodos , Imagem Cinética por Ressonância Magnética/métodos , Contração Miocárdica/fisiologia , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Algoritmos , Módulo de Elasticidade/fisiologia , Humanos , Aumento da Imagem/métodos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Magnetic resonance angiography (MRA) is clinically useful but of limited applicability to small animal models due to poor signal resolution, with typical voxel sizes of 1 mm(3) that are insufficient to analyze vessels of diameter <1 mm. We determined whether surgically implantable, extravascular MRA coils increase signal resolution adequately to examine blood flow dynamics METHODS: A custom MRA coil was surgically implanted near the carotid artery of a New Zealand White rabbit. A stenosis was created in the carotid artery to induce complicated, non-laminar flow. Phase contrast images were obtained on multiple axial planes with 3T MRA and through-plane velocity profiles were calculated under laminar and complicated flow conditions. These velocity profiles were fit to a laminar flow model using ordinary least squares in order to quantify the degree of flow complication (Matlab). Flow was also measured with a Doppler flow probe; vessel diameters and flow velocities were compared with duplex ultrasound RESULTS: Carotid artery blood flow was 24.7 +/- 2.6 ml/min prior to stenosis creation and reduced to 12.0 +/- 1.7 ml/min following injury (n=3). An MRA voxel size of 0.1 x 0.1 x 5 mm was achieved. The control carotid artery diameter was 1.9 +/- 0.1 mm, and cross-sectional images containing 318 +/- 22 voxels were acquired (n=26). Velocity profiles resembled laminar flow proximal to the stenosis, and then became more complicated just proximal and distal to the stenosis. Laminar flow conditions returned downstream of the stenosis CONCLUSION: Implantable, extra-vascular coils enable small MRA voxel sizes to reproducibly calculate complex velocity profiles under both laminar and complicated flow in a small animal model. This technique may be applied to study blood flow dynamics of vessel remodeling and atherogenesis.
Assuntos
Artérias Carótidas/fisiopatologia , Estenose das Carótidas/diagnóstico , Angiografia por Ressonância Magnética/instrumentação , Animais , Velocidade do Fluxo Sanguíneo , Artérias Carótidas/diagnóstico por imagem , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/fisiopatologia , Modelos Animais de Doenças , Desenho de Equipamento , Interpretação de Imagem Assistida por Computador , Análise dos Mínimos Quadrados , Masculino , Modelos Cardiovasculares , Valor Preditivo dos Testes , Coelhos , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Ultrassonografia DopplerRESUMO
Measurement of myocardial strain provides direct information about heart function that can be correlated with disease. We present an MRI pulse sequence that acquires in just six heartbeats both harmonic phase (HARP) and strain-encoded (SENC) images and provides dense measurements of radial, circumferential and longitudinal strains within a single short-axis slice. Normal volunteer data confirm the feasibility of this pulse sequence, and acquired data demonstrate the strain measurement reliability.
Assuntos
Imageamento Tridimensional , Imageamento por Ressonância Magnética/métodos , Contração Miocárdica/fisiologia , Adulto , Artefatos , Humanos , Processamento de Imagem Assistida por ComputadorRESUMO
MRI-based computational fluid dynamics simulations were performed in the left ventricles of two adult porcine subjects with varying physiological states (before and after an induced infarction). The hypothesis that diastolic vortices store kinetic energy and assist systolic ejection was tested, by performing systolic simulations in the presence and absence of diastolic vortices. The latter was achieved by reinitializing the entire velocity field to be zero at the beginning of systole. A rudimentary prescribed motion model of a mitral valve was included in the simulations to direct the incoming mitral jet towards the apex. Results showed that the presence or absence of diastolic vortex rings had insignificant impact on the energy expended by walls of the left ventricles for systolic ejection for both the porcine subjects, under all physiological conditions. Although substantial kinetic energy was stored in diastolic vortices by end diastole, it provided no appreciable savings during systolic ejection, and most likely continued to complete dissipation during systole. The role of diastolic vortices in apical washout was investigated by studying the cumulative mass fraction of passive dye that was ejected during systole in the presence and absence of vortices. Results indicated that the diastolic vortices play a crucial role in ensuring efficient washout of apical blood during systolic ejection.
Assuntos
Diástole/fisiologia , Hidrodinâmica , Sístole/fisiologia , Animais , Velocidade do Fluxo Sanguíneo , Simulação por Computador , Feminino , Cinética , Imageamento por Ressonância Magnética , Masculino , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiologia , Suínos , Função Ventricular Esquerda/fisiologiaRESUMO
OBJECTIVES: Tissue-engineered vascular grafts (TEVGs) have demonstrated potential for treating congenital heart disease (CHD); however, quantitative imaging for tracking functional and structural remodeling of TEVGs has not been applied. Therefore, we evaluated the potential of magnetic resonance (MR) imaging for assessing TEVG wall shear stress (WSS) and wall thickness in a large animal model. METHODS: Cell-seeded (n = 3) or unseeded (n = 3) TEVGs were implanted as inferior vena cava interposition grafts in juvenile lambs. Six months following implantation, two-dimensional phase-contrast MR imaging was performed at 3 slice locations (proximal, middle, and distal) to assess normalized WSS (i.e., WSS-to-cross sectional area). T2-weighted MR imaging was performed to assess TEVG wall thickness. Histology was qualitatively assessed, whereas immunohistochemistry was semiquantitatively assessed for smooth muscle cells (αSMA), macrophage lineage cells (CD11b), and matrix metalloproteinase activity (MMP-2 and MMP-9). Picrosirius Red staining was performed to quantify collagen content. RESULTS: TEVG wall thickness was significantly higher for proximal, middle, and distal slices in unseeded versus cell-seeded grafts. Significantly higher WSS values existed for proximal versus distal slice locations for cell-seeded TEVGs, whereas no differences in WSS existed between slices for unseeded TEVGs. Additionally, no differences in WSS existed between cell-seeded and unseeded groups. Both groups demonstrated elastin formation, without vascular calcification. Unseeded TEVGs possessed greater content of smooth muscle cells when compared with cell-seeded TEVGs. No differences in macrophage, MMP activity, or collagen content existed between groups. CONCLUSION: MR imaging allows for in vivo assessment of functional and anatomical characteristics of TEVGs and may provide a nonionizing approach that is clinically translatable to children undergoing treatment for CHD.
Assuntos
Imageamento por Ressonância Magnética , Estresse Mecânico , Engenharia Tecidual/métodos , Enxerto Vascular , Animais , Colágeno/metabolismo , Ovinos , Alicerces Teciduais/químicaRESUMO
BACKGROUND: Endovascular recanalization (guidewire traversal) of peripheral artery chronic total occlusion (CTO) can be challenging. X-ray angiography resolves CTO poorly. Virtually "blind" device advancement during x-ray-guided interventions can lead to procedure failure, perforation, and hemorrhage. Alternatively, MRI may delineate the artery within the occluded segment to enhance procedural safety and success. We hypothesized that real-time MRI (rtMRI)-guided CTO recanalization can be accomplished in an animal model. METHODS AND RESULTS: Carotid artery CTO was created by balloon injury in 19 lipid-overfed swine. After 6 to 8 weeks, 2 underwent direct necropsy analysis for histology, 3 underwent primary x-ray-guided CTO recanalization attempts, and the remaining 14 underwent rtMRI-guided recanalization attempts in a 1.5-T interventional MRI system. Real-time MRI intervention used custom CTO catheters and guidewires that incorporated MRI receiver antennae to enhance device visibility. The mean length of the occluded segments was 13.3+/-1.6 cm. The rtMRI-guided CTO recanalization was successful in 11 of 14 swine and in only 1 of 3 swine with the use of x-ray alone. After unsuccessful rtMRI (n=3), x-ray-guided attempts were also unsuccessful. CONCLUSIONS: Recanalization of long CTO is entirely feasible with the use of rtMRI guidance. Low-profile clinical-grade devices will be required to translate this experience to humans.
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Arteriopatias Oclusivas/terapia , Cateterismo/métodos , Imageamento por Ressonância Magnética , Angioplastia/instrumentação , Angioplastia/métodos , Animais , Arteriopatias Oclusivas/patologia , Doenças das Artérias Carótidas/patologia , Doenças das Artérias Carótidas/terapia , Cateterismo/instrumentação , Doença Crônica , Modelos Animais de Doenças , Desenho de Equipamento , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Doenças Vasculares Periféricas/patologia , Doenças Vasculares Periféricas/terapia , Suínos , Resultado do TratamentoRESUMO
A method to track a grid of cardiac material points in three dimensions using slice-following (SF) tagged magnetic resonance imaging (MRI) and harmonic-phase MRI is presented. A three-dimensional grid of material points on the lines of intersections of short-axis (SA) and long-axis (LA) planes is automatically tracked by combining two-dimensional pathlines that are computed on both SA and LA image planes. This process yields the true three-dimensional motion of points originating on the image plane intersections. Experimental data from normal volunteers, each obtained in four short breath-holds using the SF harmonic phase MRI pulse sequence, is presented. A validation of two-dimensional in-plane tracks using this pulse sequence on a moving phantom is also presented.
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Imageamento Tridimensional , Imageamento por Ressonância Magnética/métodos , Contração Miocárdica/fisiologia , Função Ventricular Esquerda/fisiologia , Diástole/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Imagens de Fantasmas , Sístole/fisiologiaRESUMO
Cardiovascular stress test imaging assists in the diagnosis and monitoring of cardiovascular disease. The procedure can be carried out in a magnetic resonance (MR) scanner using pharmacological agents that mimic the effects of natural exercise. In order to provide real time indication of ischemia, thereby assisting in diagnosis and helping to assure patient safety, it is desirable to have real time monitoring of the myocardial regional function. This paper presents an algorithm for the real time myocardium region-of-interest reconstruction and myocardial strain computation using data acquired from a real time pulse sequence that has been previously reported. The chirp Fourier transform is used for efficient computation, enabling a real-time continuous strain map at a rate of 25 frames/s. Coupled with a real time data path from the scanner to a laptop computer, this algorithm enables real time continuous monitoring of cardiac strain and is targeted for use in the early detection and quantification of ischemia during MR stress tests.
Assuntos
Algoritmos , Teste de Esforço/métodos , Coração/anatomia & histologia , Coração/fisiologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Sistemas Computacionais , Humanos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Cardiovascular disease is a leading cause of death worldwide, where myocardial infarction (MI) is a major category. After infarction, the heart has difficulty providing sufficient energy for circulation, and thus, understanding the heart's energy efficiency is important. We induced MI in a porcine animal model via circumflex ligation and acquired multiple-slice cine magnetic resonance (MR) images in a longitudinal manner-before infarction, and 1 week (acute) and 4 weeks (chronic) after infarction. Computational fluid dynamic simulations were performed based on MR images to obtain detailed fluid dynamics and energy dynamics of the left ventricles. Results showed that energy efficiency flow through the heart decreased at the acute time point. Since the heart was observed to experience changes in heart rate, stroke volume and chamber size over the two post-infarction time points, simulations were performed to test the effect of each of the three parameters. Increasing heart rate and stroke volume were found to significantly decrease flow energy efficiency, but the effect of chamber size was inconsistent. Strong complex interplay was observed between the three parameters, necessitating the use of non-dimensional parameterization to characterize flow energy efficiency. The ratio of Reynolds to Strouhal number, which is a form of Womersley number, was found to be the most effective non-dimensional parameter to represent energy efficiency of flow in the heart. We believe that this non-dimensional number can be computed for clinical cases via ultrasound and hypothesize that it can serve as a biomarker for clinical evaluations.
Assuntos
Metabolismo Energético , Ventrículos do Coração/fisiopatologia , Hidrodinâmica , Infarto do Miocárdio/fisiopatologia , Animais , Simulação por Computador , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Volume Sistólico , Sus scrofaRESUMO
BACKGROUND: Because ECG alterations caused by ischemia cannot be reliably detected in the high-field MRI environment, detection of wall motion abnormalities is often used to ensure patient safety during stress testing. However, an experienced observer is needed to detect these abnormalities. In this study, we investigate the use of fast harmonic phase (FastHARP) MRI for the quantitative, operator-independent detection of the onset of ischemia during acute coronary occlusion. METHODS AND RESULTS: Eight mongrel dogs underwent an acute 2-minute closed-chest coronary artery occlusion while continuous FastHARP images were acquired. Full regional wall strain was determined every other heartbeat in a single short-axis imaging slice. After 5 minutes of reperfusion, a second 2-minute ischemic episode was induced during the acquisition of conventional cine wall-motion images. The time at which ECG alterations were observed during the first ischemic period was recorded. The time from occlusion to the detection of ischemia, based on a consensus of 2 blinded observers, was determined for MRI. No significant ischemia was present in 2 animals. In the remaining animals, the onset of ischemia was detected significantly earlier by FastHARP than by cine MRI (9.5+/-5 versus 33+/-14 seconds, P<0.01). HARP ischemia detection preceded ECG changes, on average, by 54 seconds. CONCLUSIONS: The rapid acquisition and detection of induced ischemia with FastHARP MRI shows promise as a nonsubjective method to diagnose significant coronary lesions during MR stress testing.
Assuntos
Doença das Coronárias/diagnóstico , Imageamento por Ressonância Magnética/métodos , Isquemia Miocárdica/diagnóstico , Animais , Circulação Coronária , Doença das Coronárias/complicações , Doença das Coronárias/fisiopatologia , Modelos Animais de Doenças , Progressão da Doença , Cães , Eletrocardiografia , Teste de Esforço/efeitos adversos , Análise de Fourier , Frequência Cardíaca , Imagem Cinética por Ressonância Magnética , Microesferas , Contração Miocárdica , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/fisiopatologia , Reperfusão Miocárdica , Miocárdio/patologia , Valor Preditivo dos Testes , Fatores de TempoRESUMO
Pre-clinical animal models are important to study the fundamental biological and functional mechanisms involved in the longitudinal evolution of heart failure (HF). Particularly, large animal models, like nonhuman primates (NHPs), that possess greater physiological, biochemical, and phylogenetic similarity to humans are gaining interest. To assess the translatability of these models into human diseases, imaging biomarkers play a significant role in non-invasive phenotyping, prediction of downstream remodeling, and evaluation of novel experimental therapeutics. This paper sheds insight into NHP cardiac function through the quantification of magnetic resonance (MR) imaging biomarkers that comprehensively characterize the spatiotemporal dynamics of left ventricular (LV) systolic pumping and LV diastolic relaxation. MR tagging and phase contrast (PC) imaging were used to quantify NHP cardiac strain and flow. Temporal inter-relationships between rotational mechanics, myocardial strain and LV chamber flow are presented, and functional biomarkers are evaluated through test-retest repeatability and inter subject variability analyses. The temporal trends observed in strain and flow was similar to published data in humans. Our results indicate a dominant dimension based pumping during early systole, followed by a torsion dominant pumping action during late systole. Early diastole is characterized by close to 65% of untwist, the remainder of which likely contributes to efficient filling during atrial kick. Our data reveal that moderate to good intra-subject repeatability was observed for peak strain, strain-rates, E/circumferential strain-rate (CSR) ratio, E/longitudinal strain-rate (LSR) ratio, and deceleration time. The inter-subject variability was high for strain dyssynchrony, diastolic strain-rates, peak torsion and peak untwist rate. We have successfully characterized cardiac function in NHPs using MR imaging. Peak strain, average systolic strain-rate, diastolic E/CSR and E/LSR ratios, and deceleration time were identified as robust biomarkers that could potentially be applied to future pre-clinical drug studies.
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Biomarcadores , Macaca fascicularis/fisiologia , Imageamento por Ressonância Magnética , Modelos Animais , Função Ventricular Esquerda/fisiologia , Animais , Diástole , Feminino , Reprodutibilidade dos Testes , SístoleRESUMO
Cardiac motion analysis, particularly of the left ventricle (LV), can provide valuable information regarding the functional state of the heart. We propose a strategy of combining shape tracking and speckle tracking based displacements to calculate the dense deformation field of the myocardium. We introduce the use and effects of l1 regularization, which induces sparsity, in our integration method. We also introduce regularization to make the dense fields more adhering to cardiac biomechanics. Finally, we motivate the necessity of temporal coherence in the dense fields and demonstrate a way of doing so. We test our method on ultrasound (US) images acquired from six open-chested canine hearts. Baseline and post-occlusion strain results are presented for an animal, where we were able to detect significant change in the ischemic region. Six sets of strain results were also compared to strains obtained from tagged magnetic resonance (MR) data. Median correlation (with MR-tagging) coefficients of 0.73 and 0.82 were obtained for radial and circumferential strains respectively.
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Quantitative analysis of left ventricular deformation can provide valuable information about the extent of disease as well as the efficacy of treatment. In this work, we develop an adaptive multi-level compactly supported radial basis approach for deformation analysis in 3D+time echocardiography. Our method combines displacement information from shape tracking of myocardial boundaries (derived from B-mode data) with mid-wall displacements from radio-frequency-based ultrasound speckle tracking. We evaluate our methods on open-chest canines (N=8) and show that our combined approach is better correlated to magnetic resonance tagging-derived strains than either individual method. We also are able to identify regions of myocardial infarction (confirmed by postmortem analysis) using radial strain values obtained with our approach.
Assuntos
Ecocardiografia Quadridimensional/métodos , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Animais , Cães , Masculino , Movimento , Infarto do Miocárdio , Miocárdio/patologiaRESUMO
BACKGROUND: A standard quantitative imaging approach to evaluate peripheral arterial disease does not exist. Quantitative tools for evaluating arteriogenesis in vivo are not readily available, and the feasibility of monitoring serial regional changes in lower extremity perfusion has not been examined. METHODS AND RESULTS: Serial changes in lower extremity arteriogenesis and muscle perfusion were evaluated after femoral artery occlusion in a porcine model using single photon emission tomography (SPECT)/CT imaging with postmortem validation of in vivo findings using gamma counting, postmortem imaging, and histological analysis. Hybrid 201Tl SPECT/CT imaging was performed in pigs (n=8) at baseline, immediately postocclusion, and at 1 and 4 weeks postocclusion. CT imaging was used to identify muscle regions of interest in the ischemic and nonischemic hindlimbs for quantification of regional changes in CT-defined arteriogenesis and quantification of 201Tl perfusion. Four weeks postocclusion, postmortem tissue 201Tl activity was measured by gamma counting, and immunohistochemistry was performed to assess capillary density. Relative 201Tl retention (ischemic/nonischemic) was reduced immediately postocclusion in distal and proximal muscles and remained lower in calf and gluteus muscles 4 weeks later. Analysis of CT angiography revealed collateralization at 4 weeks within proximal muscles (P<0.05). SPECT perfusion correlated with tissue gamma counting at 4 weeks (P=0.01). Increased capillary density was seen within the ischemic calf at 4 weeks (P=0.004). CONCLUSIONS: 201Tl SPECT/CT imaging permits serial, regional quantification of arteriogenesis and resting tissue perfusion after limb ischemia. This approach may be effective for detection of disease and monitoring therapy in peripheral arterial disease.