# Comprehensive analysis of endocardial strain using 4DCT data

> **NIH NIH F31** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $37,897

## Abstract

Project Summary
Minimally invasive transcather-based procedures have emerged over the past decade as a therapy for selected
patients with valvular disease as an alternative to riskier open-heart surgery, particularly in patients with high
surgical risk due to multiple comorbidities. As the technology improves and successful clinical outcomes
increase, lower-risk patients are likely to be eligible for these procedures as demonstrated by recent clinical trials
for transcather aortic valve replacement. Noninvasive imaging, which has supported the growth of transcather
interventions by providing excellent preprocedural planning, could also become useful for stratifying patients
based on quantifiable prognostic parameters. For example, transcatheter mitral valve replacement (TMVR) is a
relatively new minimally invasive procedure to treat mitral regurgitation (MR); however, its effect on left ventricular
(LV) function has not yet been characterized. In addition, patients with secondary MR as a result of left ventricular
remodeling due to ischemic or idiopathic cardiomyopathy can have a large portion of their myocardium which is
already dysfunctional which requires regional characterization of LV function.
The proposed project aims to evaluate the net effect of MR and implantation of the bioprosthetic valve on LV
function by identifying akinetic, dyskinetic, hypokinetic and normal regions of myocardium before and 1-month
post minimally invasive valve replacement using noninvasive single heartbeat 4DCT-derived metrics. It is
hypothesized that the fraction and spatial distribution of normal vs. abnormal tissue will correlate with the ability
of the LV to recover post intervention. Regional maps of endocardial longitudinal strain, circumferential strain,
and rotation will be compared to traditional global metrics such as stroke volume and ejection fraction. In addition,
we will investigate the effect of the position of the bioprosthetic mitral valve device and anchoring system upon
the remodeling process of the LV by performing statistical shape modeling pre and post procedure.
In order to characterize regional myocardial function as normal or abnormal with estimated confidence intervals,
the precision of the 4DCT-derived measurement tools will be quantified. This project aims to evaluate the effect
of spatial resolution, temporal resolution, the signal-to-noise ratio, and the patient’s heart rate on the precision
of myocardial function metrics. In addition, the proposed 4DCT-derived metrics will be validated in subjects who
undergo both MRI tagging and 4DCT exams within the same day.

## Key facts

- **NIH application ID:** 9910485
- **Project number:** 1F31HL151183-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Gabrielle M. Colvert
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $37,897
- **Award type:** 1
- **Project period:** 2020-02-01 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9910485

## Citation

> US National Institutes of Health, RePORTER application 9910485, Comprehensive analysis of endocardial strain using 4DCT data (1F31HL151183-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9910485. Licensed CC0.

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