Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease
为患有缺血性心脏病的女性量身定制应激心脏 MRI
基本信息
- 批准号:10291773
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-01-01 至 2022-12-31
- 项目状态:已结题
- 来源:
- 关键词:AccountingAdenosineAffectAnatomyAngiographyBiological MarkersBlood VesselsBlood VolumeBlood capillariesBlood flowCardiacCardiovascular DiseasesCause of DeathChest PainChronicChronic Kidney FailureClinicClinical ManagementContrast MediaCoronaryCoronary AngiographyCoronary StenosisCoronary heart diseaseDataDefectDetectionDevelopmentDiagnosisDiagnosticEventExerciseFaceFemaleFoundationsFrequenciesGadoliniumHandHeartImageInjectionsInterventionIntravenousIonizing radiationIronIron deficiency anemiaIschemiaKidneyKidney DiseasesLung diseasesMagnetic ResonanceMagnetic Resonance ImagingMammary Gland ParenchymaMeasuresMedicalMetabolicMicrovascular DysfunctionModelingMorphologic artifactsMyocardialMyocardial IschemiaMyocardial tissueMyocardiumNephrogenic Systemic FibrosisNuclearObesityPatientsPatternPerformancePerfusionPerfusion Weighted MRIPharmaceutical PreparationsPre-Clinical ModelPropertyProtocols documentationRadiationRecurrenceReference StandardsRelaxationRenal functionResistanceRestRiskSafetyServicesSignal TransductionStressStress TestsSymptomsTechniquesTestingTherapeuticTherapeutic AgentsTimeTissuesTranslatingUltrasonographyVascular blood supplyVasodilationVeteransVeterans Health AdministrationWomanWorkattributable mortalitybasecommon symptomcontrast enhancedcost effectivedata acquisitiondiagnostic accuracydisabilityendothelial dysfunctionexperienceferumoxytolgraspimaging approachindexingiron deficiencymalemenmodel designporcine modelrecruitside effectsingle photon emission computed tomographysuperparamagnetismtool
项目摘要
PROJECT ABSTRACT
Chronic ischemic heart disease (IHD) is a $10.4-billion-dollar problem that is responsible for 45.1% of deaths
attributable to cardiovascular disease. Compared to men, women have a different spectrum of IHD. Current
diagnostic tools follow a one-size-fits-all model and are designed to detect a male pattern of IHD. Issues such
as breast tissue, obesity, and lung disease render easily accessible tools such as ultrasound or nuclear
SPECT imaging more limiting for women. Ischemia with no obstructive coronary disease is more common in
women compared to men; symptomatic women face higher rates of major cardiac events than asymptomatic
women. Therefore, accurate non-invasive tools that enable characterization of the entire spectrum of IHD and
its correlative ischemic burden are crucial for clinical management of women with ischemic symptoms. Invasive
interventions are without risks and lack of therapeutics contributes to disability. Myocardial ischemia occurs
when there is an imbalance between metabolic demand and blood supply. Although tissue blood supply is
affected by both myocardial blood flow (MBF) and myocardial blood volume (MBV), current stress perfusion
strategies focus on measuring deficits in MBF, which alone may not reflect all aspects of myocardial ischemia.
To better reflect the ischemic burden, we propose an MBV-based, whole-heart, gadolinium-free, non-
nephrotoxic, ferumoxytol contrast-enhanced, cardiac magnetic resonance imaging (MRI) stress testing
approach that will detect inducible ischemia. We build upon our experience in ferumoxytol-enhanced MRI and
add rigor by testing our strategy in pre-clinical models of ischemia; we efficiently translate our approach to the
clinic by validating the technique in women with IHD, some of whom require ferumoxytol for therapeutic
purposes. Because 2 billion people worldwide have iron deficiency, the dual use of ferumoxytol as a diagnostic
and therapeutic agent in the context of stress testing represents one approach to tailoring stress cardiac MRI
for women who are frequently iron deficient. Successful completion of our project would result in a gadolinium-
free, ferumoxytol-enhanced MRI stress testing approach that can reliably differentiate between normal vs
ischemic myocardial tissue and would establish a foundation for development of myocardial stress testing
approaches that enable interrogation of both epicardial and microvascular IHD.
项目摘要
慢性缺血性心脏病 (IHD) 是一个价值 104 亿美元的问题,导致 45.1% 的死亡
归因于心血管疾病。与男性相比,女性患有不同类型的 IHD。当前的
诊断工具遵循一刀切的模式,旨在检测男性 IHD 模式。诸如此类的问题
由于乳腺组织、肥胖和肺部疾病使得超声或核能等工具变得容易使用
SPECT 成像对女性的限制更大。不伴有阻塞性冠状动脉疾病的缺血更常见于
女性与男性相比;有症状的女性比无症状的女性面临更高的主要心脏事件发生率
女性。因此,准确的非侵入性工具能够表征 IHD 的整个范围,
其相关的缺血负担对于有缺血症状的女性的临床管理至关重要。侵入性
干预措施没有风险,缺乏治疗会导致残疾。出现心肌缺血
当代谢需求和血液供应不平衡时。虽然组织血液供应
受心肌血流量(MBF)和心肌血容量(MBV)共同影响,当前的应激灌注
策略的重点是测量 MBF 的缺陷,仅凭这一点可能无法反映心肌缺血的所有方面。
为了更好地反映缺血负担,我们提出了一种基于 MBV 的、全心的、无钆的、非
肾毒性、阿莫西托对比增强、心脏磁共振成像 (MRI) 压力测试
检测诱导性缺血的方法。我们以我们在阿莫西托增强 MRI 方面的经验为基础,
通过在临床前缺血模型中测试我们的策略来增加严谨性;我们有效地将我们的方法转化为
通过在患有 IHD 的女性中验证该技术,其中一些女性需要阿莫西托进行治疗
目的。由于全球有 20 亿人缺铁,因此将 ferumoxytol 用作诊断剂的双重用途
压力测试背景下的治疗剂和治疗剂代表了定制压力心脏 MRI 的一种方法
对于经常缺铁的女性。我们的项目的成功完成将产生钆-
免费的、ferumoxytol 增强的 MRI 压力测试方法,可以可靠地区分正常与
缺血心肌组织,将为心肌负荷测试的发展奠定基础
能够询问心外膜和微血管 IHD 的方法。
项目成果
期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kim-Lien T Nguyen其他文献
Kim-Lien T Nguyen的其他文献
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{{ truncateString('Kim-Lien T Nguyen', 18)}}的其他基金
Cardiac MRI for Reperfusion Spatial Mapping to Improve Heart Failure Outcomes
心脏 MRI 进行再灌注空间测绘以改善心力衰竭的预后
- 批准号:
10717212 - 财政年份:2023
- 资助金额:
-- - 项目类别:
Ferumoxytol-Enhanced Cardiac MRI for Ischemic Heart Disease
Ferumoxytol 增强心脏 MRI 治疗缺血性心脏病
- 批准号:
10452731 - 财政年份:2020
- 资助金额:
-- - 项目类别:
Ferumoxytol-Enhanced Cardiac MRI for Ischemic Heart Disease
Ferumoxytol 增强心脏 MRI 治疗缺血性心脏病
- 批准号:
10200137 - 财政年份:2020
- 资助金额:
-- - 项目类别:
Ferumoxytol-Enhanced Cardiac MRI for Ischemic Heart Disease
Ferumoxytol 增强心脏 MRI 治疗缺血性心脏病
- 批准号:
10649655 - 财政年份:2020
- 资助金额:
-- - 项目类别:
Ferumoxytol-Enhanced Cardiac MRI for Ischemic Heart Disease
Ferumoxytol 增强心脏 MRI 治疗缺血性心脏病
- 批准号:
9973771 - 财政年份:2020
- 资助金额:
-- - 项目类别:
Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease
为患有缺血性心脏病的女性量身定制应激心脏 MRI
- 批准号:
9850863 - 财政年份:2019
- 资助金额:
-- - 项目类别:
Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease
为患有缺血性心脏病的女性量身定制应激心脏 MRI
- 批准号:
10683714 - 财政年份:2019
- 资助金额:
-- - 项目类别:
Tailoring Stress Cardiac MRI for Women with Ischemic Heart Disease
为患有缺血性心脏病的女性量身定制应激心脏 MRI
- 批准号:
10426232 - 财政年份:2019
- 资助金额:
-- - 项目类别:
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