Cardiovascular diseases rank as America's primary killer, claiming the lives of over 41% of more than 2.4 million Americans who die each year. One of the main reasons for this high number of lives lost is the severe lack of an effective imaging technique for early detection and localization of an abnormality upon anomaly detected on the electrocardiogram (ECG). It has been established that the mechanical and electrical properties of the myocardium change dramatically as a result of a myocardial ischemia;both at its onset and after survival. Despite these findings, no imaging technique currently exists that is routinely used in the clinic and can provide reliable, non-invasive, quantitative mapping of the regional, mechanical and electrical function of the myocardium. The underlying hypothesis of the renewal study is that elastographic techniques can detect and diagnose both the mechanical and electrical properties of the myocardium, both in its normal and disease, i.e., ischemic and infarcted, states. We propose to use this multi-dimensional, angle-independent elastographic technique at variable heart rates for early detection of disease based on its altered mechanical and electrical properties of the myocardium, which can now be obtained simultaneously. Most importantly, we propose to carefully assess its potential in the clinic for early detection and localization of ischemia by developing an optimized system that can be easily be integrated with standard echocardiography. To this purpose, a multidisciplinary team of investigators from Columbia University and Johns Hopkins University has been assembled. In order to test the aforementioned hypothesis, we propose the following specific aims: 1) determine capability of estimation of both electrical and mechanical properties of normal and ischemic/infarcted myocardium using a bi-domain simulation model;2) develop upgraded system and test performance on tissue-mimicking phantoms undergoing 3D deformation and propagating waves;3) validate and combine estimation of electrical and mechanical properties in the canine myocardium for early detection of ischemia and infarction;and 4) optimize and validate localization of ischemia or arrhythmia in humans against angiography and electroanatomic mapping, respectively. Should the results of this study indicate high reliability of the elastographic findings for detection of early ischemic onset, this novel imaging system could be readily tested in a clinical setting as part of a standard protocol for early ischemia and infarction detection and its subsequent timely treatment.
Cardiovascular diseases rank as America's primary killer in both men and women, claiming the lives of over 41% of more than 2.4 million Americans who die each year. Myocardial elastography is a unique technique that may be capable of mapping both the mechanical and electrical properties of the myocardium for early detection of disease.
|Bunting, E A; Provost, J; Konofagou, E E (2014) Stochastic precision analysis of 2D cardiac strain estimation in vivo. Phys Med Biol 59:6841-58|
|Hou, Gary Y; Provost, Jean; Grondin, Julien et al. (2014) Sparse matrix beamforming and image reconstruction for 2-D HIFU monitoring using harmonic motion imaging for focused ultrasound (HMIFU) with in vitro validation. IEEE Trans Med Imaging 33:2107-17|
|Costet, Alexandre; Provost, Jean; Gambhir, Alok et al. (2014) Electromechanical wave imaging of biologically and electrically paced canine hearts in vivo. Ultrasound Med Biol 40:177-87|
|Provost, Jean; Gambhir, Alok; Vest, John et al. (2013) A clinical feasibility study of atrial and ventricular electromechanical wave imaging. Heart Rhythm 10:856-62|
|Provost, Jean; Thiebaut, Stephane; Luo, Jianwen et al. (2012) Single-heartbeat electromechanical wave imaging with optimal strain estimation using temporally unequispaced acquisition sequences. Phys Med Biol 57:1095-112|
|Konofagou, Elisa E; Provost, Jean (2012) Electromechanical wave imaging for noninvasive mapping of the 3D electrical activation sequence in canines and humans in vivo. J Biomech 45:856-64|
|Luo, Jianwen; Li, Ronny X; Konofagou, Elisa E (2012) Pulse wave imaging of the human carotid artery: an in vivo feasibility study. IEEE Trans Ultrason Ferroelectr Freq Control 59:174-81|
|Provost, Jean; Lee, Wei-Ning; Fujikura, Kana et al. (2011) Imaging the electromechanical activity of the heart in vivo. Proc Natl Acad Sci U S A 108:8565-70|
|Provost, Jean; Gurev, Viatcheslav; Trayanova, Natalia et al. (2011) Mapping of cardiac electrical activation with electromechanical wave imaging: an in silico-in vivo reciprocity study. Heart Rhythm 8:752-9|
|Konofagou, Elisa; Lee, Wei-Ning; Luo, Jianwen et al. (2011) Physiologic cardiovascular strain and intrinsic wave imaging. Annu Rev Biomed Eng 13:477-505|
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