Early Detection of Vascular Dysfunction Using Biomarkers from Lagrangian Carotid Strain Imaging

使用拉格朗日颈动脉应变成像生物标志物早期检测血管功能障碍

基本信息

批准号：
10653121
负责人：
TOMY VARGHESE
金额：
$ 58.49万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10653121
关键词：
3-Dimensional Age Age Years Aging Algorithms Arterial Fatty Streak Arteries Atherosclerosis Biochemical Biological Markers Blood Blood Pressure Blood Vessels Blood flow Cardiac Carotid Arteries Carotid Endarterectomy Cerebrovascular system Characteristics Classification Clinical Code Cognition Color Deposition Development Disease Early Diagnosis Embolism Fostering Frequencies General Population Goals Grant Guidelines Histopathology Human Volunteers Hyperlipidemia Hypertension Image Individual Intervention Lateral Life Style Modification Location Longitudinal Studies Magnetic Resonance Imaging Measurement Measures Medical Methods Modulus Noise Pathologic Patients Performance Physiological Population Populations at Risk Predisposition Protocols documentation Research Risk Rupture Scanning Screening procedure Sequoia Severities Signal Transduction Stenosis Stream Stress Stroke Structure Subgroup System Therapeutic Embolization Time Tissues Ulcer Ultrasonography Validation Variant Vascular Cognitive Impairment Vascular Diseases Work age group age related clinical imaging clinically significant cost feeding high risk population human data human subject imaging approach imaging study improved in vivo indexing innovation interest mechanical properties novel novel strategies plaque lesion pressure reconstruction response screening trend ultrasound vascular risk factor volunteer

项目摘要

Abstract Current clinical criteria for treatment of atherosclerotic plaque, or atheromas, have focused primarily on percent stenosis of the vessel. However, measures of occlusion (percent stenosis) do not identify those plaques that are prone to rupture, which may release emboli into the blood stream feeding sensitive cerebral vasculature. A novel approach, Lagrangian carotid strain imaging, where tissue displacements are precisely measured during pulsation of blood through the artery has been developed. We propose to measure `strain indices,' that include the maximum accumulated axial, lateral, and shear strain estimated over the cardiac cycle, to probe the detailed mechanical properties of early plaque. We believe these strain indices will prove to be valuable vascular biomarkers to indicate vascular aging and possible plaque vulnerability. Our preliminary results demonstrate the ability to differentiate between soft and stiff regions in plaque under in-vivo clinical imaging conditions. Our definition of `vulnerable plaque' or `vulnerable patient' relies on the identification of lipidic depositions or softer plaques, i.e., those that undergo large axial or lateral deformations and/or large shearing strains during the cardiac cycle. Capability of strain tensor imaging and vascular biomarkers to characterize plaque severity from its early stages to a mature plaque lesion will be evaluated and quantified. A study on asymptomatic volunteers and patients also is proposed. The volunteer will provide values for vascular strain indices normalized to age-related vascular stiffening. The results will enable us to establish trends in age-related variations in vascular stiffness and to determine deviations that could establish vascular aging criteria. Interventions to reverse vascular aging might then be used, for example lifestyle modifications and common medical therapies. Strain imaging results will be validated and complimented by three- dimensional (3D) carotid magnetic resonance imaging (MRI) on a selected group of high-risk volunteers, along with 3D carotid MRI and 3D histopathological analysis of the entire excised plaque on patients to better understand plaque composition and structure. Validation of our results will foster use of real-time noninvasive ultrasound strain imaging as a screening tool for identifying human subjects susceptible to vascular aging and/or developing plaque prone to rupture or micro-embolization that could lead to `silent strokes' and possible vascular cognitive impairment. The patient study will also enable comparison of strain indices and carotid MRI to the ground truth, namely the excised plaque.

抽象的目前用于治疗动脉粥样硬化斑块或动脉瘤的临床标准主要集中在血管的狭窄百分比。但是，闭塞度量（狭窄百分比）无法识别容易破裂的斑块，可能将栓子释放到血流摄入敏感的脑中脉管系统。一种新颖的方法，即拉格朗日颈动脉菌株成像，组织位移精确在通过动脉搏动期间测量的血液脉动。我们建议测量劳力索引，包括心脏估计的最大累积轴向，侧向和剪切应变循环，以探测早期斑块的详细机械性能。我们认为这些应变指数将证明成为有价值的血管生物标志物，以表明血管衰老和可能的斑块脆弱性。我们的初步结果证明了斑块中的软和刚性区域区分的能力在体内临床成像条件下。我们对“脆弱牌匾”或“脆弱患者”的定义依赖脂质沉积或较软的斑块的鉴定，即发生较大轴向或侧面的斑块心脏周期期间的变形和/或大剪切菌株。应变张量成像的能力和血管生物标志物是从早期阶段到成熟斑块病变的牙菌斑严重程度的表征评估和量化。还提出了一项关于无症状志愿者和患者的研究。志愿者将提供价值对于血管应变指数，已归一化为年龄相关的血管僵硬。结果将使我们能够建立与年龄相关的血管刚度变化的趋势，并确定可能建立血管的偏差老化标准。然后可以使用逆转血管衰老的干预措施，例如生活方式修改和常见的医疗疗法。应变成像结果将得到三分之二的验证和称赞沿选定的一组高风险志愿者的尺寸（3D）颈动脉磁共振成像（MRI）沿通过3D颈动脉MRI和3D组织病理学分析对患者的整个切除斑块，以更好地了解斑块组成和结构。验证我们的结果将促进实时无创的使用超声应变成像作为筛选工具，用于识别易受血管衰老的人类受试者和/或开发易于破裂或微启用的斑块，可能导致“沉默中风”并可能血管认知障碍。患者研究还将可以比较应变指数和颈动脉MRI 关于地面的真理，即切除的牌匾。