Cardiac Blood Flow Patterns Associated With Left Ventricular Myocardial Damage

Study Overview
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Brief Summary
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Various factors affect the performance of the heart: The contractile properties of myocardial muscle cells are the fundamental devices for translating tension-generation and shortening of the cardiac muscle into pressure-generation and blood volume ejection from the heart into the body. On the other hand, the performance of heart can be analyzed with respect to input and output of blood to/from the hollow cardiac muscle and evaluated in terms of the performance of a pump: With every heartbeat blood is sucked from a low-pressure system (veins) and pumped to the arterial high-pressure system via one-way valves, whereas efficiency, ejected blood volume, blood flow and pressures are linked by hemodynamic laws. Cardiac magnetic resonance (CMR) is the gold standard technique to determine cardiac function and muscle mass, as well as for non-invasive diagnosis of myocardial necrosis/fibrosis. Furthermore, new CMR imaging techniques enabling the measurement of myocardial magnetic relaxation times for characterization of myocardial morphology and the acquisition of time-resolved, three-dimensional blood flow velocity fields in the heart and surrounding vessels, represent promising tools for the evaluation of the interaction between myocardial morphology and cardiac function. Aim of this explorative study is to 1. identify myocardial pathology-associated blood flow patterns in the heart and surrounding great vessels, and 2. correlate characteristic blood flow patterns in the heat (existence of vortices, vorticity, vortex formation, propagation dynamics …) with myocardial injuries.

Official Title
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Cardiac Blood Flow Patterns Associated With Regional and Global Left Ventricular Myocardial Damage: an Explorative Study by Cardiac Magnetic Resonance

Conditions
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Healthy, Cardiomyopathies, Myocardial Injury

Intervention / Treatment
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* Diagnostic Test: Single Group Assignment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients age 20-80 years, patients with and without ischemic or non-ischemic myocardial injuries scheduled for routine cardiac magnetic resonance imaging, ability to hold the breath, ability to give informed consent Exclusion Criteria: patients with metal devices or other magnetic material in or on the subjects body which will be hazardous for magnetic resonance investigation (e.g. heart pace-maker, brain aneurysm clip, nerve stimulators, electrodes, penile implants, colored contact lenses, patch to deliver medications through the skin, any metal implants as rods, joints, plates, pins, screws, nails or clips, embolization coil, or any metal fragments or shrapnel in the body), patients with tendency toward claustrophobia, hemodynamically unstable patients, patients with (major) arrhythmia pregnancy, impaired kidney function indicated by creatin clearance lower than 60 ml/min (creatin clearance will be calculated according to Cockroft-Gault formula)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Myocardial Injury<br>patients with myocardial injuries due to ischemic heart disease, patients with myocardial injuries due to non-ischemic heart disease. | Diagnostic Test: Single Group Assignment<br> <br> |
| No Myocardial Injury<br>subjects without myocardial injuries with normal cardiac function subjects without myocardial injuries with altered cardiac function | Diagnostic Test: Single Group Assignment<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Myocardial pathology-associated blood flow patterns in the heart and surrounding great vessels | Morphologic, functional and blood flow CMR parameters will be evaluated with different techniques. Cardiac blood flow pattern parameters will be correlated with myocardial injury derived non-invasively from late gadolinium enhancement | 2 years |