Comprehensive Clinical Assessment of Pediatric PHT

儿科 PHT 的综合临床评估

• 批准号: 7138563
• 负责人: ROBIN SHANDAS
• 金额: $ 12.45万
• 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/7138563
• 关键词: bioimaging /biomedical imaging; biomechanics; blood flow measurement; cardiovascular disorder diagnosis; cardiovascular function; cardiovascular imaging /visualization; catheterization; children; clinical research; computer simulation; echocardiography; hemodynamics; human subject; hypertension; noninvasive diagnosis; patient oriented research; pediatrics; pulmonary artery; radiodiagnosis; shear stress; ultrasound blood flow measurement; vascular resistance

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)在儿童中是一种相对较少被了解的疾病，需要持续监测和长期治疗以减轻过多的右室后负荷效应。这样的监测需要定期的、经常是侵入性的临床成像会议。然而，即使使用有创技术，目前获得的临床信息也是不完整的，主要涉及肺血管阻力(PVR)及其组成部分参数：平均肺动脉压(PA)和右心输出量(QP)。鉴于目前可用于临床评估PAH的定量信息的匮乏，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也应该有助于新的非侵入性诊断的发展，通过允许更容易地获取肺血管特征、连续监测和床边反应性评估，应该扩大临床医生描述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(僵硬或顺应性)和稳态(阻力)分量。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射器的研究，以及研究开发新的非侵入性诊断方法，以提取在侵入性测量中发现的相关参数 阻抗，即PVR和肺血管硬度(PVS)。这个K24项目提出了一种独特的研究和培训工作的组合，以推进对PAH的临床评估，同时培训临床研究人员，使他们对潜在的物理学和血流动力学有坚实的基础了解，并将这些原则准确地应用于新的临床诊断。