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）是儿童相对较少了解的疾病，需要持续的监测和长期治疗，以减轻过多的右心室后负荷作用。这种监测需要定期且经常侵入性的临床成像会议。但是，即使使用侵入性技术，当前获得的临床信息的程度也不完整，主要涉及肺血管耐药性（PVR）及其成分参数：平均肺动脉（PA）压力（PA）压力（PA）压力（PA）和右侧心脏输出（QP）。鉴于目前可用于在临床上评估PAH的定量信息很少，因此存在使用先进的心血管成像和复杂计算建模的组合来开发和评估PAH的更全面度量的机会。此外，从此类努力中获得的信息也应有助于开发新型的非侵入性诊断，该诊断可以通过更轻松地获取肺血管特征，连续监测和反应性床边评估，这应该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衡量，因为阻抗包括动态（刚度或依从性）和稳态（电阻）（电阻）（电阻）组件。因此，该项目的目的分为研究，以建立临床上的阻抗使用，探索阻抗为何是肺血管血流动力学和力学的良好反射剂，以及开发出新的非侵入性诊断的研究，这些诊断可提取在侵袭性较高的参数中发现的相关参数 阻抗，即PVR和肺血管刚度（PVS）。该K24项目提出了研究研究和培训工作的独特组合，以提高对PAH的临床评估，同时培训临床研究研究员，对基本物理学和血液动力学的基本了解以及将这种原理的准确应用到新的临床诊断中。