Comprehensive Clinical Assessment of Pediatric PHT

儿科 PHT 的综合临床评估

• 批准号: 7679689
• 负责人: ROBIN SHANDAS
• 金额: $ 13.61万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7679689
• 关键词: Blood Vessels; Cardiac Output; Characteristics; Child; Childhood; Chronic; Clinical; Clinical Research; Clinical assessments; Complex; Computer Simulation; Development; Diagnostic; Disease; Evaluation; Image; Lung; Measures; Mechanics; Monitor; Physics; Pulmonary Vascular Resistance; Pulmonary artery structure; Research; Resistance; Side; Solid; Techniques; Training; Ventricular; cardiovascular imaging; electric impedance; hemodynamics; novel; pressure; pulmonary arterial hypertension; research clinical testing; research study

DESCRIPTION (provided by applicant): Pulmonary arterial hypertension (PAH) is a relatively poorly understood disease in children and requires constant monitoring and chronic treatment to mitigate excess right ventricular afterload effects. Such monitoring requires regular and frequently invasive clinical imaging sessions. However, even with invasive techniques, the extent of clinical information currently obtained is incomplete, involving primarily pulmonary vascular resistance (PVR) and its component parameters: mean pulmonary artery (PA) pressure and right sided cardiac output (Qp). Given this paucity of quantitative information currently available to evaluate PAH clinically, opportunities exist to develop and evaluate more comprehensive measures of PAH using a combination of advanced cardiovascular imaging and sophisticated computational modeling. Furthermore, information gained from such endeavors should also assist in the development of novel non-invasive diagnostics, which by allowing easier acquisition of pulmonary vascular characteristics, serial monitoring, and bedside evaluation of reactivity, should widen the clinician's ability to characterize this complex disease. The overall hypothesis for these studies is that pulmonary vascular input impedance provides a more comprehensive measure of pulmonary vascular function than PVR alone since impedance includes both dynamic (stiffness or compliance) and steady-state (resistance) components of the vascular circuit. The aims of this project are therefore divided into studies establishing the use of impedance clinically, studies exploring why impedance is a good reflector of pulmonary vascular hemodynamics and mechanics, and studies developing novel non-invasive diagnostics that extract the relevant parameters found in invasivelymeasured impedance, namely PVR and pulmonary vascular stiffness (PVS). This K24 project proposes a unique combination of research studies and training efforts to advance clinical evaluation of PAH while training clinical research fellows with both solid fundamental understanding of underlying physics and hemodynamics and accurate application of such principles to novel clinical diagnostics.

描述（由申请人提供）： 肺动脉高压（PAH）是一种相对知之甚少的儿童疾病，需要持续监测和长期治疗，以减轻过度的右心室后负荷影响。这种监测需要定期且频繁的侵入性临床成像。然而，即使采用侵入性技术，目前获得的临床信息也不完整，主要涉及肺血管阻力（PVR）及其组成参数：平均肺动脉（PA）压力和右侧心输出量（Qp）。鉴于目前可用于临床评估 PAH 的定量信息匮乏，因此有机会结合先进的心血管成像和复杂的计算模型来开发和评估更全面的 PAH 测量方法。此外，从这些努力中获得的信息还应有助于新型非侵入性诊断的开发，通过更容易地获取肺血管特征、连续监测和床边反应性评估，应扩大临床医生表征这种复杂疾病的能力。这些研究的总体假设是，肺血管输入阻抗比单独的 PVR 提供了更全面的肺血管功能测量，因为阻抗包括血管回路的动态（刚度或顺应性）和稳态（阻力）组成部分。因此，该项目的目标分为建立阻抗在临床上的应用的研究、探索为什么阻抗是肺血管血流动力学和力学的良好反映者的研究，以及开发新型非侵入性诊断的研究，以提取侵入性测量中发现的相关参数。 阻抗，即PVR和肺血管僵硬度（PVS）。该 K24 项目提出了研究和培训工作的独特结合，以推进 PAH 的临床评估，同时培训临床研究人员，使他们对基础物理学和血流动力学有扎实的基础了解，并将这些原理准确应用于新型临床诊断。