Comprehensive Assessment of Right Ventricular and Pulmonary Vascular Function via CT Imaging in Heart Failure Patients

CT成像综合评估心力衰竭患者右心室和肺血管功能

• 批准号: 10224766
• 负责人: Francisco J Contijoch
• 金额: $ 16.04万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224766
• 关键词: Address; Area; Award; Biomedical Engineering; Biometry; Blood Vessels; Cardiac; Cardiology; Clinical; Clinical Research; Communities; Complex; Coupling; Destinations; Dose; Echocardiography; Educational process of instructing; Effectiveness; Energy Supply; Engineering; Environment; Exposure to; Failure; Freedom; Functional disorder; Future; Gold; Head; Heart; Heart Transplantation; Heart failure; Image; Imaging Techniques; Impairment; International; Intervention; Left; Left Ventricular Function; Lung; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Medicine; Mentorship; Methods; Multimodal Imaging; Muscle Cells; Myocardial; Operative Surgical Procedures; Patients; Physiology; Probability; Property; Publications; Pulmonary artery structure; Pump; Radiology Specialty; Research; Research Institute; Research Project Grants; Research Proposals; Resistance; Resources; Right Ventricular Dysfunction; Right Ventricular Function; Right ventricular structure; Stretching; Surface; Techniques; Testing; Training; Translational Research; Transplantation; Validation; Ventricular; Ventricular Function; Visualization; Writing; X-Ray Computed Tomography; base; career; clinical predictors; clinical risk; cost; design; experience; foot; graduate student; heart function; hemodynamics; high risk; image processing; image reconstruction; implantation; improved; improved outcome; left ventricular assist device; meetings; mortality; novel; patient oriented research; pressure; prevent; professional atmosphere; success; treatment strategy

Project Summary: Mechanical circulatory support is required by a large percentage of patients who undergo heart transplant and serves as a destination therapy for end-stage heart failure patients who are ineligible for transplant. However, clinicians are currently unable to predict the up to 40% of patients who develop right heart failure after receiving left ventricular assist devices. If identified pre-operatively, these patients could receive planned biventricular support which has been shown to improve outcomes. Unfortunately, pre-operative hemodynamic parameters, echocardiographic measures, and clinical risk scores have shown limited effectiveness in identifying these patients. The hypothesis of this project is that load-independent measures of ventricular function and assessment of ventricular-arterial coupling are necessary to improve prediction of right heart function and failure in patients receiving left ventricular assist devices. To investigate this hypothesis, we will develop and validate novel CT-based techniques which allow for comprehensive and simultaneous assessment of the right ventricle and pulmonary arteries in a single heartbeat. By acquiring these novel measures along with gold-standard estimates in clinical patients, we will validate whether measures of ventricular-arterial coupling can be obtained with cineCT. Furthermore, acquiring multi-modality images in clinical patients undergoing left ventricular assist device implantation will allow for assessment of whether measures of ventricular-arterial coupling provide clinically predictive information regarding post-implantation right ventricular function (and failure). The proposal includes a training plan designed to address gaps in the applicant’s technical and professional experiences and help launch his independent research career. Specifically, the training includes: didactic coursework in biostatistics, patient-oriented research, and grant writing, training in navigating the academic work environment, mentorship in multi-modality imaging and pulmonary vascular physiology, clinical exposure to the management and treatment of heart failure patients, exposure to potential graduate students through teaching of imaging-focused coursework, and increased exposure to the international research community via publications and attendance and presentations at annual meetings. UC San Diego is the optimal environment for this award. In addition to support by world-class facilities and collaborators in the Bioengineering, Radiology, and Cardiology departments, the applicant and research proposal will have a very high probability of success given the benefit of and access to campus-wide resources such as the Altman Clinical and Translational Research Institute and Institute for Engineering in Medicine.

项目摘要： 大部分接受心脏移植和的患者需要机械电路支撑 作为无资格进行移植的终阶段心力衰竭患者的目的地疗法。然而， 目前，临床医生无法预测多达40％的患者，患有正确的心力衰竭 接收左心室辅助设备。如果在术前确定，这些患者可以接受计划 室内支持可以改善预后。不幸的是，术前血流动力学 参数，超声心动图测量和临床风险评分在 确定这些患者。该项目的假设是与负载无关的度量 需要进行心室功能和心室耦合的评估以改善 预测接受左心室辅助装置的患者的右心功能和衰竭。 为了研究这一假设，我们将开发并验证基于CT的新技术，以允许 对右心室和肺动脉的全面评估 心跳。通过获取这些新型措施以及临床患者的金标准估计值，我们将 验证是否可以通过Cinect获得心室耦合的度量。此外，还在赞美 接受左心室辅助装置植入的临床患者的多模式图像将允许 评估心室耦合度量是否提供临床预测信息 关于植入后右心室功能（和失败）。 该提案包括一个培训计划，旨在解决申请人技术和专业人士的差距 经验并帮助启动他的独立研究生涯。具体而言，培训包括：教学 生物统计学，面向患者的研究和赠款写作的课程工作，培训学术 工作环境，多模式成像中的心态和肺血管生理学，临床暴露 为了管理和治疗心力衰竭患者，通过 以成像为重点的课程教学，并通过 在年度会议上出版，出勤和演讲。加州大学圣地亚哥加州大学是最佳环境 为此奖励。除了世界一流的设施和合作者的支持外， 放射学和心脏病学部门，申请人和研究建议的可能性很高 鉴于Altman临床等校园资源的利益并获得了成功的成功 翻译研究所和医学工程研究所。