Exercise, Power Loss and the Fontan: Are They Linked?

锻炼、功率损失和 Fontan：它们有联系吗？

• 批准号: 7686960
• 负责人: KEVIN K WHITEHEAD
• 金额: $ 13.84万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7686960
• 关键词: 3-Dimensional; Accounting; Adult; Affect; Age; Anatomy; Bicycling; Blood; Blood Circulation; Blood flow; Caliber; Cardiac; Cardiac Output; Cardiac Surgery procedures; Cardiology; Childhood; Classification; Clinical; Common Ventricle; Complex; Computer Simulation; Congenital Abnormality; Data; Decision Making; Elements; Engineering; Evaluation; Exercise; Exercise Physiology; Exercise stress test; Failure; Goals; Heart; Heart Atrium; Heart Diseases; Heart failure; Image; Institutes; Institution; Investigation; Knowledge; Lateral; Life; Link; Liquid substance; Lung; Lung diseases; Magnetic Resonance; Magnetic Resonance Imaging; Measures; Medical; Mentors; Metabolic; Methodology; Modeling; Modification; Operative Surgical Procedures; Outcome; Oxygen; Patient Care; Patients; Performance; Physiology; Play; Population; Population Heterogeneity; Principal Investigator; Procedures; Process; Protein-Losing Enteropathies; Protocols documentation; Public Health; Pulmonary artery structure; Pulsatile Flow; Pump; Relative (related person); Research; Research Personnel; Research Proposals; Resolution; Rest; Right atrial structure; Role; Running; Series; Side; Simulate; Staging; Stenosis; Surgeon; Techniques; Technology; Time; Training; Translating; Venous; Venous Pressure level; Ventricular; Work; abstracting; cardiovascular imaging; career; clinically significant; congenital heart disorder; driving force; experience; hemodynamics; image processing; improved; interest; patient oriented; pressure; programs; reconstruction; research study; response; simulation; tool

DESCRIPTION (provided by applicant): Candidate's Plans/Training: The candidate plans a career as a patient-oriented researcher leveraging knowledge in fluid dynamics and image processing to further the practice of pediatric cardiology and cardiovascular imaging. My major research interest involves using fluid dynamic analysis in order to better understand the physiology of congenital heart disease, especially single ventricle physiology. Training will include formal imaging and computational fluid dynamics coursework, and closely mentored completion of the research protocol from both experienced clinical and technical mentors. Research: The group of patients with single ventricle physiology has probably seen more advancement in surgical technique and management than any other group of patients with congenital heart disease in the last two decades. However, they remain the most challenging group of patients to manage. The currently accepted technique of managing single ventricle patients generally involves three stages of surgery which culminate in the total cavopulmonary connection (TCPC). Because relatively small energy losses in the TCPC might result in the long-term failure of this physiology, it is becoming increasingly clear that these losses cannot be ignored. To this end, the primary aims of this proposal are: 1) to characterize the power loss of the TCPC of anatomical Fontan reconstructions under both resting and exercise conditions and to determine whether this power loss relates to exercise performance; 2) study the differences in the flow fields and power loss of extracardiac and lateral tunnel Fontans to determine if one is energetically more favorable; 3) to utilize exercise testing during cardiac magnetic resonance (CMR) using an MRI-compatible exercise bicycle to further our understanding of the Fontan physiology under resting and exercise conditions. These aims will be studied using a combination of patient data (MRI's and exercise tests) and MRI-derived anatomically correct computer models of blood flow through these patients' TCPC using finite element computational fluid dynamic analysis. Public Health: The proposed research will add to our knowledge of how to care for patients with complex birth defects involving the heart, specifically patients with a single ventricle. These patients make up a growing population of adults as about 2000 per year are saved and most are surviving into adulthood. (End of Abstract)

描述（由申请人提供）：候选人的计划/培训：候选人计划从事以患者为导向的研究人员的职业，利用流体动力学和图像处理知识，以进一步进一步实践儿科心脏病学和心血管成像。我的主要研究兴趣涉及使用液体动态分析，以更好地了解先天性心脏病的生理学，尤其是单脑室生理学。培训将包括正式的成像和计算流体动力学课程，以及经验丰富的临床和技术导师的研究方案的密切指导。研究：在过去的二十年中，单个心室生理学的患者组可能比其他任何患有先天性心脏病的患者的手术技术和管理进步要多。但是，它们仍然是最具挑战性的患者组。当前管理单个心室患者的技术通常涉及三个阶段的手术​​阶段，这些阶段最终在整个Cavopulonary Connection（TCPC）中达到顶峰。由于TCPC中相对较小的能量损失可能会导致这种生理学的长期失败，因此越来越清楚这些损失不容忽视。为此，该提案的主要目的是：1）表征解剖学方坦在休息和运动条件下重建TCPC的功率损失，并确定这种功率损失是否与运动性能有关； 2）研究流场的差异以及心外隧道和外侧隧道的功率损失，以确定一个人在能量上是否更有利； 3）使用与MRI兼容的运动自行车在心脏磁共振（CMR）期间使用运动测试，以进一步了解我们对静止和运动条件下的Fontan生理学的理解。这些目标将使用患者数据（MRI和运动测试）和MRI衍生的解剖学上正确的血液流动计算机模型通过这些患者的TCPC使用有限元计算流体动力学分析来研究这些目标。公共卫生：拟议的研究将增加我们如何护理涉及心脏的复杂出生缺陷的患者，特别是具有单个心室的患者。这些患者构成了越来越多的成年人人口，因为每年约有2000名被保存，大多数人都可以生存到成年。 （抽象的结尾）