Advanced Imaging and Diagnostics for Pediatric Pulmonary Hypertension

肺动脉高压(PAH)是一种在儿童中相对鲜为人知的疾病，需要 持续监测和慢性治疗以减轻过多的右室后负荷效应。是这样的 监测需要定期和经常侵入性的临床成像会议。然而，即使在入侵的情况下 技术，目前获得的临床信息的范围是不完整的，主要涉及肺脏 血管阻力(PVR)及其组成参数：平均肺动脉压和右肺动脉压 单侧心输出量(QP)。鉴于目前可用于评估多环芳烃的定量信息的匮乏 在临床上，有机会开发和评估更全面的PAH措施，使用 结合先进的心血管成像和复杂的计算建模。此外， 从这种努力中获得的信息也应该有助于开发新的非侵入性 诊断学，通过允许更容易地获取肺血管特征、连续监测、 而床边的反应性评估，应该会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，肺血管输入阻抗提供了更多 肺血管功能的综合测量比PVR单独测量更好，因为阻抗包括两者 血管回路的动态(刚性或柔顺性)和稳态(阻力)组件。这个 因此，该项目的目标被划分为建立阻抗在临床上的使用的研究、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，以及 研究开发新的非侵入性诊断方法，提取侵入性- 测量阻抗，即PVR和肺血管硬度(PVS)。

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 invasively- measured impedance, namely PVR and pulmonary vascular stiffness (PVS).