Patient-Specific Coronary Hemodynamics by 3D Printing

通过 3D 打印进行患者特定的冠状动脉血流动力学

• 批准号: 10386845
• 负责人: Simon Dunham
• 金额: $ 64.04万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10386845
• 关键词: 3-Dimensional; 3D Print; Accounting; Adult; Anatomy; Arterial Fatty Streak; Arteries; Blood Circulation; Blood Pressure; Cessation of life; Characteristics; Clinical; Clinical Data; Clinical Trials; Complex; Computer software; Coronary; Coronary Arteriosclerosis; Coronary artery; Couples; Data; Diagnosis; Diagnostic; Dose; Elastomers; Electrocardiogram; Equipment; Evaluation; Exercise; Functional disorder; Goals; Gold; Grant; Heart Rate; Hospitalization; Human; Image; In Vitro; Individual; Intervention; Ischemia; Label; Life; Measurement; Measures; Mechanics; Methods; Modeling; Multicenter Studies; Multicenter Trials; Myocardial; Myocardial Ischemia; Myocardial perfusion; Myocardium; Outcome; Oxygen Consumption; Patients; Performance; Perfusion; Physical activity; Physiological; Positron-Emission Tomography; Property; Pulsatile Flow; Reporting; Resistance; Severities; Stenosis; Stress; Stress Tests; Symptoms; System; Techniques; Testing; Tissues; United States National Institutes of Health; Velocimetries; X-Ray Computed Tomography; accurate diagnosis; base; burden of illness; clinical imaging; exercise capacity; experimental study; hemodynamics; imaging modality; improved; in vitro testing; in vivo; individual variation; innovation; non-invasive system; novel; particle; performance tests; personalized diagnostics; pre-clinical; predictive modeling; pressure; sensor; targeted treatment; three-dimensional modeling

ABSTRACT. Despite improvements in therapies targeted at reducing disease burden, CAD continues to afflict >16 million US adults, accounting for more than 1/3 of all deaths and responsible for ~1.2 million hospitalizations annually. Coronary revascularization remains a mainstay of treatment for CAD, with >1.2 million percutaneous interventions performed annually in the US. Prior multicenter trials have demonstrated propitious outcomes for individuals with who undergo ischemia-guided revascularization by fractional flow reserve (FFR)—an invasive “gold” standard that determines the physiologic significance of coronary stenoses. More recently we have studied the accuracy of a non-invasive CT-based alternative to FFR, termed FFRCT. While this new method is moderately accurate, it possesses several limitations such as assuming the walls of the coronaries are rigid and flow is non-pulsatile. Therefore, we have determined an alternative approach to assessing coronary hemodynamics via 3D printing, which allows physical measurements of coronary flow using realistic tissue mechanics and pulsatile flow. In this application, we will optimize the hardware, software, workflows, and analysis to build and evaluate coronary hemodynamics based on patient CT images. Extensive clinical imaging data, including 15O-H2O labeled PET imaging will be used to validate the accuracy of these models for predicting coronary hemodynamics. Finally, these 3D printed models will be used to develop clinically useful reports that can provide diagnostic determination of a patient's level of ischemia using only non-invasive CT imaging.

抽象的。尽管针对减少疾病伯恩的疗法有所改善，但CAD仍继续影响 > 1600万美国成年人，占所有死亡人数超过1/3，负责约120万 每年住院。冠状动脉血运重建仍然是CAD治疗的主要手段，> 1.2 每年在美国进行百万经皮干预措施。先前的多中心试验已证明 对于通过分数流进行缺血引导血运重建的人来说，有利的结果 储备金（FFR） - 一种侵入性的“黄金”标准，它决定了冠状动脉sten虫的生理意义。 最近，我们研究了称为FFRCT的非侵入性CT替代方案的准确性。 尽管这种新方法适度准确，但它具有多个限制，例如假设 冠状动脉是刚性的，流量是非脉冲的。因此，我们已经确定了另一种方法 通过3D打印评估冠状动脉血流动力学，允许物理测量冠状动脉流动 使用逼真的组织力学和脉动流动。在此应用程序中，我们将优化硬件，软件， 工作流以及根据患者CT图像建立和评估冠状动脉血流动力学的分析。 广泛的临床成像数据（包括15o-H2O标记的PET成像）将用于验证准确性 这些用于预测冠状动脉血流动力学的模型。最后，这些3D打印模型将用于开发 临床上有用的报告，可以仅使用使用的诊断确定患者缺血水平 非侵入性CT成像。

项目成果

Sex Differences in Cardiovascular Imaging.

心血管成像的性别差异。

• DOI: 10.1016/j.jcmg.2016.02.011
• 发表时间: 2016
• 期刊: JACC. Cardiovascular imaging
• 作者: Shaw,LesleeJ

Response to letter regarding article, "Noninvasive fractional flow reserve derived from computed tomography angiography for coronary lesions of intermediate stenosis severity: results from the DeFACTO study".

对有关文章“针对中度狭窄严重程度的冠状动脉病变的计算机断层扫描血管造影得出的无创血流储备分数：DeFACTO 研究的结果”的回复。

• DOI: 10.1161/circimaging.114.001523
• 发表时间: 2014
• 期刊: Circulation. Cardiovascular imaging
• 作者: Nakazato,Ryo;Park,Hyung-Bok;Berman,DanielS;Gransar,Heidi;Koo,Bon-Kwon;Erglis,Andrejs;Lin,FayY;Dunning,AllisonM;Budoff,MatthewJ;Malpeso,Jennifer;Leipsic,Jonathon;Min,JamesK
• 通讯作者: Min,JamesK