Quantification and Characterization of Coronary Atherosclerotic Plaque by CT

CT 冠状动脉粥样硬化斑块的定量和表征

• 批准号: 8790457
• 负责人: Armin A. Zadeh
• 金额: $ 13.97万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-17 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8790457
• 关键词: Advisory Committees; Agreement; Anatomy; Angiography; Arterial Fatty Streak; Award; Baltimore; Biometry; Calcified; Cardiac; Cardiac Death; Cardiology; Characteristics; Clinical; Clinical Investigator; Clinical Research; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary artery; Detection; Diagnosis; Enrollment; Environment; Epidemiology; Event; Excision; Faculty; Generations; Goals; Gold; Health; Healthcare Systems; Heart Transplantation; High Prevalence; Histopathology; Hospitals; Human; Image; International; Investigation; Laboratories; Lead; Lesion; Location; Maryland; Master' s Degree; Measurement; Mentors; Methods; Modeling; Monitor; Multicenter Studies; Myocardial; Myocardial Infarction; Nuclear; Outcome; Outcome Study; Patient Schedules; Patients; Perfusion; Population; Prevention; Prevention strategy; Public Health; Public Health Schools; Relative (related person); Research; Research Personnel; Resources; Risk; Schools; Severities; Slice; Societies; Solid; Stenosis; Stress; Stress Tests; Techniques; Testing; Thallium Myocardial Perfusion Imaging Stress Test; Training; Training Programs; Translating; Ultrasonography; Universities; Validation; Work; X-Ray Computed Tomography; attenuation; base; cardiovascular disorder epidemiology; career; cohort; design; detector; diagnostic accuracy; experience; follow-up; improved; in vivo; medical schools; novel; patient oriented research; population based; prognostic; prospective; statistics; tool; trial design

DESCRIPTION (provided by applicant): Dr. Zadeh is an academic cardiologist at the Johns Hopkins Hospital in Baltimore, Maryland. He devoted most of his career to patient oriented research with a particular focus on diagnosis and prevention of coronary artery disease. Dr. Zadeh gathered considerable expertise in the use of intravascular ultrasound, conventional coronary angiography, and cardiac computed tomography for the detection and characterization of coronary artery disease. During his first three years on the faculty in the Division of Cardiology at the Johns Hopkins Hospital he was an integral part of a multicenter, international study to evaluate the accuracy of multi-detector computed tomography (MDCT) to detect obstructive coronary artery disease in comparison to conventional angiography. Dr. Zadeh is now the Associate Director of Cardiac CT at the Johns Hopkins Hospital and the Director of the Cardiac CT coronary angiography core laboratory for a second international study comparing MDCT to nuclear stress perfusion imaging and conventional angiography. Dr. Zadeh's long term career goal is to become an independent clinical investigator with the specific objective to translate the new and abundant information from non-invasive coronary artery imaging into improved cardiac event prediction models for population based application and patient management. Ultimately, his goal is to contribute to a decrease in the rates of myocardial infarction and cardiac death in our society and worldwide by implementing better prevention strategies. This award application is designed to advance Dr. Zadeh from the status of a mentored researcher with a solid background in clinical research but with deficiencies in biostatistics and epidemiology to an independent clinical investigator who is able to design and conduct clinical outcome studies based on experience in coronary imaging and coronary artery disease. The objectives of this award will be accomplished through 1) a comprehensive didactic training program in biomedical statistics and epidemiology and 2) the experience of conducting supervised research, which is directly applicable to his long term goal. Specifically, the focus of the first three years of this award will be intensive course work in biomedical statistics, cardiovascular epidemiology, and trial design at the Bloomberg School of Public Health which will lead to a master degree in public health within 3 years. The proposed research plan consists of three parts. Part 1 consists of a retrospective analysis to validate MDCT assessment of total coronary atherosclerotic plaque volume and plaque characteristics compared to intravascular ultrasound in 32 patients enrolled in the CorE-64 multicenter study. The novel aspects of this analysis are the first attempt to fully quantify total coronary atherosclerotic plaque burden by MDCT in comparison to an established standard and the first use of relative attenuation measurements for a more robust assessment of plaque characterization. Part 2 includes a prospective analysis of 320-slice CT for the assessment of total coronary atherosclerotic plaque volume and plaque characteristics compared to histopathology in 30 patients scheduled to undergo heart transplantation. This will be the first such study using current generation MDCT. The unique opportunity to acquire MDCT images in vivo before heart transplantation analysis and ex vivo immediately after excision in comparison to histopathology will provide invaluable information regarding the ability of MDCT to assess coronary artery disease. Lastly, in a third step these validated methods of coronary atherosclerotic plaque volume and characteristics analysis will be applied to predict the risk of cardiac events in 400 patients who are being enrolled for the CorE-320 multicenter study, a diagnostic accuracy study to compare MDCT assessment of coronary anatomy and myocardial stress perfusion imaging to conventional angiography and nuclear stress testing, during a 5-year follow up. Dr. Zadeh's progress to achieving the status of an independent clinical investigator will be closely monitored by his mentor, co-mentor, and a mentoring advisory committee. The Johns Hopkins University School of Medicine and Bloomberg School of Public provide an outstanding training environment and thus are ideally suited to support Dr. Zadeh's transition to an independent investigator with focus on patient-oriented research.

描述（由申请人提供）：Zadeh博士是马里兰州巴尔的摩约翰霍普金斯医院的学术心脏病专家。他的大部分职业生涯都致力于以患者为导向的研究，特别关注冠状动脉疾病的诊断和预防。Zadeh博士在使用血管内超声、常规冠状动脉造影和心脏计算机断层扫描检测和表征冠状动脉疾病方面积累了相当多的专业知识。在约翰霍普金斯医院心脏科任教的前三年，他是一项多中心国际研究的组成部分，该研究旨在评价多探测器计算机断层扫描（MDCT）与传统血管造影术相比检测阻塞性冠状动脉疾病的准确性。Zadeh博士现在是约翰霍普金斯医院心脏CT的副主任，也是心脏CT冠状动脉造影核心实验室的主任，负责第二项比较MDCT与核负荷灌注成像和传统血管造影的国际研究。Zadeh博士的长期职业目标是成为一名独立的临床研究者，具体目标是将来自无创冠状动脉成像的新的丰富信息转化为改进的心脏事件预测模型，用于基于人群的应用和患者管理。最终，他的目标是通过实施更好的预防策略，为降低我们社会和世界范围内的心肌梗死和心脏死亡率做出贡献。该奖项旨在将Zadeh博士从临床研究背景扎实，但在生物统计学和流行病学方面存在缺陷的指导研究员地位提升为能够根据冠状动脉成像和冠状动脉疾病经验设计和进行临床结局研究的独立临床研究者。该奖项的目标将通过1）生物医学统计学和流行病学的综合教学培训计划和2）进行监督研究的经验来实现，这直接适用于他的长期目标。具体来说，该奖项的前三年的重点将是在彭博公共卫生学院的生物医学统计学，心血管流行病学和试验设计的密集课程工作，这将导致在3年内获得公共卫生硕士学位。拟议的研究计划包括三个部分。第1部分包括一项回顾性分析，旨在验证在CorE-64多中心研究中入组的32例患者中，与血管内超声相比，MDCT对冠状动脉粥样硬化斑块总体积和斑块特征的评估。该分析的新方面是首次尝试通过MDCT与已建立的标准进行比较来完全量化总冠状动脉粥样硬化斑块负荷，以及首次使用相对衰减测量来更可靠地评估斑块特征。第2部分包括320层CT的前瞻性分析，用于评估总冠状动脉粥样硬化斑块体积和斑块特征，并与30例计划接受心脏移植的患者的组织病理学进行比较。这将是第一个使用当前一代MDCT的此类研究。与组织病理学相比，在心脏移植分析之前在体内和切除后立即在体外获得MDCT图像的独特机会将提供关于MDCT评估冠状动脉疾病的能力的宝贵信息。最后，在第三步中，这些经验证的冠状动脉粥样硬化斑块体积和特征分析方法将用于预测入组CorE-320多中心研究的400例患者的心脏事件风险，该研究是一项诊断准确性研究，旨在将冠状动脉解剖结构和心肌负荷灌注成像的MDCT评估与传统血管造影和核负荷试验进行比较，在5年的随访中。Zadeh博士取得独立临床研究者地位的进展将由他的导师、共同导师和指导咨询委员会密切监测。约翰霍普金斯大学医学院和彭博公共学院提供了一个出色的培训环境，因此非常适合支持扎德博士过渡到一个独立的研究者，专注于以病人为导向的研究。

项目成果

Access site bleeding after transcatheter aortic valve implantation.

经导管主动脉瓣植入后通路部位出血。

• DOI: 10.1007/s11239-013-0928-6
• 发表时间: 2013
• 期刊: Journal of thrombosis and thrombolysis
• 影响因子: 4
• 作者: Sharma,Abhishek;Arbab-Zadeh,Armin;Dubey,Divyanshu;Shani,Jacob;Lazar,Jason;Frankel,Robert
• 通讯作者: Frankel,Robert

Nuclear stress perfusion imaging versus computed tomography coronary angiography for identifying patients with obstructive coronary artery disease as defined by conventional angiography: insights from the CorE-64 multicenter study

核应力灌注成像与计算机断层扫描冠状动脉造影用于识别传统血管造影定义的阻塞性冠状动脉疾病患者：CorE-64 多中心研究的见解

• DOI: 10.5301/heart.2014.12493
• 发表时间: 2014
• 期刊: Heart International
• 影响因子: 0.2
• 作者: Y. Tanami;Julie M. Miller;A. Vavere;C. Rochitte;M. Dewey;H. Niinuma;M. Clouse;Christopher Cox;J. Brinker;J. Lima;A. Arbab
• 通讯作者: A. Arbab

Patterns of coronary arterial lesion calcification by a novel, cross-sectional CT angiographic assessment.

• DOI: 10.1007/s10554-013-0240-8
• 发表时间: 2013-10
• 期刊: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
• 影响因子: 2.1
• 作者: Cerci, Rodrigo;Vavere, Andrea L.;Miller, Julie M.;Yoneyama, Kihei;Rochitte, Carlos E.;Dewey, Marc;Niinuma, Hiroyuki;Clouse, Melvin E.;Laham, Roger;Bush, David E.;Shapiro, Edward P.;Lardo, Albert C.;Cox, Christopher;Brinker, Jeffrey;Lima, Joao A. C.;Arbab-Zadeh, Armin
• 通讯作者: Arbab-Zadeh, Armin

Fractional flow reserve-guided percutaneous coronary intervention is not a valid concept.

• DOI: 10.1161/circulationaha.113.003583
• 发表时间: 2014-05-06
• 期刊: Circulation
• 影响因子: 37.8
• 作者: Arbab-Zadeh A

Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm.

• DOI: 10.4081/hi.2012.e2
• 发表时间: 2012-02-03
• 期刊: Heart international
• 影响因子: 0.2
• 作者: Arbab-Zadeh A