Final Report Summary - HEART4FLOW (Improved Diagnosis and Management of Heart Disease by 4D Blood Flow Assessment)
The primary purpose of the cardiovascular system is to drive, control and maintain blood flow to all parts of the body. Despite the primacy of flow, cardiac diagnostics still rely almost exclusively on tools focused on morphological assessment.
The objective of the HEART4FLOW project is to develop the next generation of methods for the non-invasive quantitative assessment of cardiac diseases and therapies by focusing on blood flow dynamics, with the goals of earlier and more accurate detection and improved management of cardiac diseases.
Using 4D flow magnetic resonance imaging (MRI), the time-resolved, three-dimensional (time + 3D = 4D) blood flow velocity and turbulence intensity can be measured in the heart. In the HEART4FLOW project, this technique is extended and exploited for non-invasive assessment of blood flow dynamics in the human heart. Therefore, the project aimed to improve the acquisition of the data, improve the analysis of blood flow energetics and wall interaction, as well as the assessment of blood flow through constricted, also called stenotic, heart valves.
The 4D flow MRI acquisition was enhanced by the development of a retrospectively ecg-gated spiral 4D flow MRI sequence. This spiral 4D flow MRI sequence showed to be more than three times faster and less sensitive to artifacts in jet flow when compared with a conventional Cartesian sequence, facilitating 4D flow MRI of valve disease in the clinical workflow.
Novel user-friendly quantitative assessment techniques for assessment of intracardiac blood flow energetics have been developed. Is was shown that blood flow volumes and visualizations can be obtained fully automatically using an atlas-based registration technique that allows for segmentation and analysis of 4D flow MRI data in the large vessels. This is a major step towards usage of the technique in large clinical trails and clinical applications.
Simultaneously, a novel technique for the measurement of the complete turbulent stress tensor has been developed in collaboration with researchers at UCSF, San Francisco. Access to this tensor showed to allow for accurate estimation of the irreversible pressure drop over a stenosis in a range of stenoses. These data can, furthermore, be used to assess hemodynamic blood damage.
The developed techniques have been utilized and evaluated on normal volunteers and heart patients. The technique showed to be able to already detect subtle changes in left ventricular remodeling and dysfunction. Utilization of the techniques on other diseases is expected to lead to further insight into cardiac function, while the techniques also have great potential to enhance clinical diagnosis.
The objective of the HEART4FLOW project is to develop the next generation of methods for the non-invasive quantitative assessment of cardiac diseases and therapies by focusing on blood flow dynamics, with the goals of earlier and more accurate detection and improved management of cardiac diseases.
Using 4D flow magnetic resonance imaging (MRI), the time-resolved, three-dimensional (time + 3D = 4D) blood flow velocity and turbulence intensity can be measured in the heart. In the HEART4FLOW project, this technique is extended and exploited for non-invasive assessment of blood flow dynamics in the human heart. Therefore, the project aimed to improve the acquisition of the data, improve the analysis of blood flow energetics and wall interaction, as well as the assessment of blood flow through constricted, also called stenotic, heart valves.
The 4D flow MRI acquisition was enhanced by the development of a retrospectively ecg-gated spiral 4D flow MRI sequence. This spiral 4D flow MRI sequence showed to be more than three times faster and less sensitive to artifacts in jet flow when compared with a conventional Cartesian sequence, facilitating 4D flow MRI of valve disease in the clinical workflow.
Novel user-friendly quantitative assessment techniques for assessment of intracardiac blood flow energetics have been developed. Is was shown that blood flow volumes and visualizations can be obtained fully automatically using an atlas-based registration technique that allows for segmentation and analysis of 4D flow MRI data in the large vessels. This is a major step towards usage of the technique in large clinical trails and clinical applications.
Simultaneously, a novel technique for the measurement of the complete turbulent stress tensor has been developed in collaboration with researchers at UCSF, San Francisco. Access to this tensor showed to allow for accurate estimation of the irreversible pressure drop over a stenosis in a range of stenoses. These data can, furthermore, be used to assess hemodynamic blood damage.
The developed techniques have been utilized and evaluated on normal volunteers and heart patients. The technique showed to be able to already detect subtle changes in left ventricular remodeling and dysfunction. Utilization of the techniques on other diseases is expected to lead to further insight into cardiac function, while the techniques also have great potential to enhance clinical diagnosis.