MRI methods for predicting response to cardiac resynchronization therapy

Suever, Jonathan D.

Title:

MRI methods for predicting response to cardiac resynchronization therapy

dc.contributor.advisor	Oshinski, John N.
dc.contributor.author	Suever, Jonathan D.
dc.contributor.committeeMember	Brummer, Marijn E.
dc.contributor.committeeMember	Lloyd, Michael S.
dc.contributor.committeeMember	Sechopoulos, Ioannis
dc.contributor.committeeMember	Tang, Xiangyang
dc.contributor.committeeMember	Yezzi, Anthony J.
dc.contributor.department	Biomedical Engineering (Joint GT/Emory Department)
dc.date.accessioned	2014-01-13T16:19:42Z
dc.date.available	2014-01-13T16:19:42Z
dc.date.created	2013-12
dc.date.issued	2013-08-02
dc.date.submitted	December 2013
dc.date.updated	2014-01-13T16:19:42Z
dc.description.abstract	Cardiac Resynchronization Therapy (CRT) is a treatment option for heart failure patients with ventricular dyssynchrony. CRT corrects for dyssynchrony by electrically stimulating the septal and lateral walls of the left ventricle (LV), forcing synchronous con- traction and improving cardiac output. Current selection criteria for CRT rely upon the QRS duration, measured from a surface electrocardiogram, as a marker of electrical dyssynchrony. Unfortunately, 30-40% of patients undergoing CRT fail to benefit from the treatment. A multitude of studies have shown that presence of mechanical dyssynchrony in the LV is an important factor in determining if a patient will benefit from CRT. Furthermore, recent evidence suggests that patient response can be improved by placing the LV pacing lead in the most dyssynchronous or latest contracting segment. The overall goal of this project was to develop methods that allow for accurate assessment and display of regional mechanical dyssynchrony throughout the LV and at the site of the LV pacing lead. To accomplish this goal, we developed a method for quantifying regional dyssynchrony from standard short-axis cine magnetic resonance (MR) images. To assess the effects of LV lead placement, we developed a registration method that allows us to project the LV lead location from dual-plane fluoroscopy onto MR measurements of cardiac function. By applying these techniques in patients undergoing CRT, we were able to investigate the relationship between regional dyssynchrony, LV pacing lead location, and CRT response.
dc.description.degree	Ph.D.
dc.format.mimetype	application/pdf
dc.identifier.uri	http://hdl.handle.net/1853/50224
dc.language.iso	en_US
dc.publisher	Georgia Institute of Technology
dc.subject	Magnetic resonance imaging
dc.subject	Cardiac resynchronization therapy
dc.subject	Electrophysiology
dc.subject	Image processing
dc.subject.lcsh	Heart failure
dc.subject.lcsh	Heart Magnetic resonance imaging
dc.subject.lcsh	Cardiac pacing
dc.subject.lcsh	Electric stimulation
dc.subject.lcsh	Congestive heart failure Treatment
dc.title	MRI methods for predicting response to cardiac resynchronization therapy
dc.type	Text
dc.type.genre	Dissertation
dspace.entity.type	Publication
local.contributor.advisor	Oshinski, John N.
local.contributor.corporatename	Wallace H. Coulter Department of Biomedical Engineering
local.contributor.corporatename	College of Engineering
local.relation.ispartofseries	Doctor of Philosophy with a Major in Biomedical Engineering
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relation.isSeriesOfPublication	d85f9f1b-b2b5-4bca-81af-4515c5281e54
thesis.degree.level	Doctoral