Advanced CMR Tissue-Based Prediction of Right Ventricular Dysfunction and Revascularization Response

基于先进 CMR 组织的右心室功能障碍和血运重建反应预测

• 批准号: 10318575
• 负责人: Jiwon Kim
• 金额: $ 16.92万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-12-15 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10318575
• 关键词: 3-Dimensional; Affect; Area; Arts; Biometry; Breathing; Cardiac; Cardiopulmonary; Center for Translational Science Activities; Cessation of life; Clinical; Clinical Investigator; Complement; Complex; Coronary; Coronary Arteriosclerosis; Data; Decision Making; Detection; Development; Diagnosis; Echocardiography; Epidemiology; Exercise Physiology; Exercise Test; Exercise Tolerance; Fatty acid glycerol esters; Foundational Skills; Functional disorder; Future; Geometry; Goals; Heart failure; Image; Infarction; Interdisciplinary Study; Ischemia; Knowledge; Left; Link; Magnetic Resonance; Master' s Degree; Measures; Mediating; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Motion; Myocardial Infarction; Myocardial tissue; Myocardium; Outcome; Patient-Focused Outcomes; Patients; Performance; Physics; Physiologic pulse; Population Study; Prevalence; Principal Investigator; Prognosis; Property; Protocols documentation; Research; Research Personnel; Resolution; Resources; Respiratory Diaphragm; Right Ventricular Dysfunction; Right ventricular structure; Risk; Risk Factors; Severities; Stress; Structure; Techniques; Technology; Testing; Therapeutic; Therapeutic Effect; Thinness; Tissues; Training; Translational Research; United States National Institutes of Health; Ventricular; base; cardiac magnetic resonance imaging; clinical investigation; coronary perfusion; design; experience; functional improvement; hemodynamics; imaging approach; imaging modality; improved; improved functioning; indexing; lung pressure; mortality risk; multidisciplinary; necrotic tissue; novel; pulmonary arterial pressure; response; right ventricular remodeling; risk stratification; stem; ultrasound

PROJECT SUMMARY / ABSTRACT This K23 application for Dr. Jiwon Kim will enable her to develop as an independent clinical investigator focused on the use of novel imaging strategies to improve risk stratification among patients with heart failure and coronary artery disease (CAD). A K23 award will allow Dr. Kim to attain expertise in 3 areas: (1) new cardiac MRI (CMR) approaches for improved tissue characterization of the right ventricle (RV), (2) advanced echocardiography techniques to be applied for the RV in population based studies, (3) principles of clinical investigation needed to initiate independent design and execution of sophisticated research protocols. To pursue these goals, Dr. Kim has assembled a multidisciplinary mentoring team. Her primary mentor, Dr. Weinsaft, is the principal investigator of the R01 to which this K23 is paired and has extensive research experience in CMR assessment of myocardial tissue properties. Dr. Wang is a co-mentor with an established track record in high-resolution CMR pulse sequence development. Dr. Devereux is a secondary co-mentor with expertise in cardiac ultrasound and epidemiology. The goal of Dr. Kim's K23 research is to identify myocardial tissue-based markers of RV dysfunction among CAD patients. RV dysfunction occurs in up to 40% of patients with CAD and has been shown to independently increase risk of death. Altered myocardial tissue properties is a potential causative substrate for RV dysfunction but has not yet been studied in this context due to limited ability to visualize infarction in the thin RV wall. New high-resolution techniques (3D navigator CMR) including those that have the possibility to be tailored for the RV (RV epicardial fat navigator) may improve RV tissue characterization. To test these concepts, 150 patients with CAD undergoing stress CMR pre- and post- revascularization will be studied. Stress CMR will be used to determine relationships between left and right ventricular tissue properties (ischemia and infarction) and RV function (Aim 1). To optimize RV myocardial infarction (RV-MI) detection, the RV will be assessed using standard 2D CMR and new 3D CMR technologies (RV epicardial fat navigator) (Aim 2). To test the concept that revascularization may improve RV function, RV-MI will be studied as a marker for irreversible RV dysfunction: RV-MI will be used to predict RV functional improvement following coronary revascularization (Aim 3A). Lastly, to study the impact of RV-MI on functional consequences, RV-MI will be studied in relation to effort tolerance on cardiopulmonary exercise testing (Aim 3B). This training and research plan will leverage existing multidisciplinary collaborations and institutional resources including Dr. Weinsaft's R01 from which imaging data will be drawn and the Cornell Clinical Translational Science Center through which a Master's degree will be obtained in Clinical Investigation. Finally, this research will inform future R01 applications, which will test new high resolution approaches for RV coronary perfusion and study RV functional response to coronary revascularization in viable but ischemic RV.

项目摘要/摘要

项目成果

Moving Beyond Right Ventricular Ejection Fraction: Incremental Prognostic Role of Right Ventricular Strain on Postcardiac Transplant Outcomes.

超越右心室射血分数：右心室应变对心脏移植结果的增量预后作用。

• DOI: 10.1161/circimaging.124.016789
• 发表时间: 2024
• 期刊: Circulation. Cardiovascular imaging
• 作者: Owyang,ClarkG;Kim,Jiwon
• 通讯作者: Kim,Jiwon

Cardiovascular magnetic resonance for evaluation of cardiac involvement in COVID-19: recommendations by the Society for Cardiovascular Magnetic Resonance.

• DOI: 10.1186/s12968-023-00933-0
• 发表时间: 2023-03-27
• 期刊: Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

Cardiac quantitative susceptibility mapping (QSM) for heart chamber oxygenation.

• DOI: 10.1002/mrm.26808
• 发表时间: 2018-03
• 期刊: Magnetic resonance in medicine
• 影响因子: 3.3
• 作者: Wen Y;Nguyen TD;Liu Z;Spincemaille P;Zhou D;Dimov A;Kee Y;Deh K;Kim J;Weinsaft JW;Wang Y
• 通讯作者: Wang Y

Impact of acute TTE-evidenced cardiac dysfunction on in-hospital and outpatient mortality: A multicenter NYC COVID-19 registry study.

• DOI: 10.1371/journal.pone.0283708
• 发表时间: 2023
• 期刊: PloS one
• 影响因子: 3.7

Muscle Matters: CMR Tissue Characterization for Mechanistically Tailored Risk Stratification of Functional Mitral Regurgitation.

肌肉很重要：CMR 组织表征，用于功能性二尖瓣反流的机械定制风险分层。

• DOI: 10.1161/circimaging.123.015808
• 发表时间: 2023
• 期刊: Circulation. Cardiovascular imaging
• 作者: Kim,Jiwon;VillarCalle,Pablo;Weinsaft,JonathanW
• 通讯作者: Weinsaft,JonathanW