Advanced cardiac imaging analysis in atrial fibrillation and its hemodynamics

Kim, Hansuk

Advanced cardiac imaging analysis in atrial fibrillation and its hemodynamics

dc.contributor.advisor	Garcia Flores, Julio
dc.contributor.author	Kim, Hansuk
dc.contributor.committeemember	Fear, Elise
dc.contributor.committeemember	Wilton, Stephen B.
dc.date.accessioned	2024-01-03T16:43:03Z
dc.date.available	2024-01-03T16:43:03Z
dc.date.issued	2023-12-20
dc.description.abstract	Atrial fibrillation (AF) is a prevalent cardiac disorder characterized by rapid and disorganized atrial activation, resulting in impaired atrial function. With a global impact affecting approximately 33.5 million individuals, AF leads to an elevated risk of complications such as thromboembolism and stroke. Current treatment guidelines primarily rely on patient demographics and medical history, yet a more precise therapeutic approach based on individual flow is required. 4D flow magnetic resonance imaging (MRI) offers comprehensive measurement of flow velocity throughout the entire cardiac cycle in three dimensions. While previous studies have explored the application of 4D flow techniques in AF, they have encountered limitations related to resolution and contrast, particularly when segmenting the fine structures of the left atrium (LA). Furthermore, the clinical parameters derived from 4D flow MRI in AF have been relatively limited, and there has been notable absence of studies focused on assessing flow recovery after catheter ablation. This research addresses the technical and clinical gaps in previous studies, aiming to enhance the clinical applicability of 4D flow imaging techniques in AF. In clinical aspect, our investigation explores the impact of AF on left ventricular (LV) flow in paroxysmal AF using LV flow component analysis. This analysis unveils subtle alterations in LV flow efficiency, even in patients with paroxysmal AF and normal systolic function, indicating hemodynamic changes without signs of adverse LV remodeling. Our comparative study of LA flow in AF patients before and after catheter ablation reveals significant changes in LA blood flow stasis using 4D flow imaging. To overcome the limitations of resolution and contrast of 4D flow, we propose a segmentation method utilizing standard-of-care contrast-enhanced magnetic resonance angiography (CE-MRA) and a registration process with 4D flow data. In conclusion, this thesis advances the application of 4D-flow MRI in AF studies, offering novel insights and clinically relevant findings. These findings pave the way for more precise and individualized therapeutic strategies in the management of AF.
dc.identifier.uri	https://hdl.handle.net/1880/117824
dc.language.iso	en
dc.publisher.faculty	Graduate Studies
dc.publisher.institution	University of Calgary
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subject	4D flow MRI
dc.subject	atrial fibrillation
dc.subject	magnetic resoance imaging
dc.subject	image processing
dc.subject	cardiovascular
dc.subject	hemodynamics
dc.subject.classification	Engineering--Biomedical
dc.subject.classification	Radiology
dc.title	Advanced cardiac imaging analysis in atrial fibrillation and its hemodynamics
dc.type	doctoral thesis
thesis.degree.discipline	Engineering – Biomedical
thesis.degree.grantor	University of Calgary
thesis.degree.name	Doctor of Philosophy (PhD)
ucalgary.thesis.accesssetbystudent	I do not require a thesis withhold – my thesis will have open access and can be viewed and downloaded publicly as soon as possible.