Accurate, Needle-Free, MRI-based Detection of Ischemic Heart Disease without Contrast Agents
无需造影剂即可通过 MRI 进行准确、无针、基于 MRI 的缺血性心脏病检测
基本信息
- 批准号:9981378
- 负责人:
- 金额:$ 81.59万
- 依托单位:
- 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:2020-06-24 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdenosineAffectAlgorithmic AnalysisAmericanAmmoniaAngioplastyAnimal ModelAnimalsBrainBreathingCarbon DioxideCardiacCardiovascular systemCaringCause of DeathCessation of lifeClinicalContrast MediaCoronary Artery BypassCoronary StenosisCoronary arteryDataDetectionDevelopmentDiseaseDisease SurveillanceEarly InterventionElectrocardiogramEnd stage renal failureEventExerciseFaceFunctional Magnetic Resonance ImagingFundingGeneral PopulationGoldHeartHospitalizationHypercapniaImageImpairmentInjectableIntravenousIonizing radiationIonsIschemiaKineticsMagnetic Resonance ImagingMapsMeasurementMedicalMethodsMicrovascular DysfunctionMotionMyocardialMyocardial IschemiaMyocardiumNeedlesOperative Surgical ProceduresOxygenPartial PressurePatientsPerfusionPharmacologyPhysiologicalPositron-Emission TomographyPress ReleasesPrevalencePublishingRadialRadiationReportingResolutionRiskSafetyScienceSensitivity and SpecificitySeveritiesSignal TransductionStatistical AlgorithmStimulusStressStress TestsTestingThallium Myocardial Perfusion Imaging Stress TestTimeTranslatingTranslationsUnited StatesUnited States National Institutes of HealthValidationbaseblood oxygen level dependentcardiovascular risk factorclinically relevantclinically significantclinically translatablecompliance behaviorcomputer frameworkcoronary vasodilatorcost effectivehigh riskimage processingimprovedinsightmortalitypreventprognostic valueprospectivereconstructionresearch clinical testingsingle photon emission computed tomographytargeted imaging
项目摘要
PROJECT SUMMARY
Ischemic heart disease (IHD) is the leading cause of death in the United States. It emanates from narrowing of
coronary arteries (CAD) and/or development of microvascular dysfunction culminating in myocardial ischemia
– a condition where the oxygen demand of the myocardium is far in excess of the available supply. IHD
accounts for more than 1 in 3 deaths and >1 million hospitalizations each year in the US. The extent and
severity of myocardial ischemia has been shown to provide incremental prognostic value over standard clinical
variables across the spectrum of presentation of patients with IHD. Long-established (SPECT or PET) and
more recently established (e.g., first pass-perfusion MRI) methods are routinely used to gather this information.
In spite of their capabilities, these methods have key limitations – they expose the patients to either ionizing
radiation or exogenous contrast agents, which carry risks to the patients. This is particularly a critical problem
in at least half a million patients with end-stage renal disease (ESRD) in the US. In ESRD patients, annual
ischemia testing is needed since the risk of cardiovascular mortality is > 10-fold greater than in the general
population. Hence there is an unmet and growing need for safe and reliable assessment of myocardial
ischemia in all patients, and is most pressing in ESRD patients, whose prevalence in the US is on the rise.
Blood-Oxygen-Level-Dependent (BOLD) Cardiac MRI (CMR) is a potential alternative to standard clinical
methods since it is free of ionizing radiation and exogenous contrast media. It also has the capability to provide
physiological insight into the disease based on measurements of impaired oxygen supply, and not from
surrogate metrics (wall motion, ECG changes, or contrast kinetics). Over the past two decades, the technical
capabilities of BOLD CMR have led to clinical testing. However, limitations in reliability (sensitivity, specificity
and accuracy) remain a major impediment for widespread clinical use of BOLD CMR. To overcome the
reliability limitations of BOLD CMR, in a previous R01 funding (2013 to 2017), we hypothesized that repeat
stimulations of the heart, analogous to brain activation studies using BOLD MRI (brain fMRI), could improve
the reliability of BOLD CMR. Subsequently, we went onto demonstrate that (i) a targeted change in arterial
partial pressure of CO2 (PaCO2) can be a potent non-invasive vasoactive stimulus; and a (ii) high-resolution,
whole heart BOLD CMR at 3T with repeat PaCO2 stimulation of the heart, when combined with a statistical
framework, can reliably detect BOLD signal changes in large, healthy, animals. To successfully translate the
promising impact of this BOLD CMR approach into the clinical arena, further advances and validation will be
required. This proposal aims to continue the successful advancement of this BOLD CMR approach towards
clinical feasibility so that it can enable a truly noninvasive and cost-effective ischemia testing that is free of
ionizing radiation, exogenous contrast agents, intravenous pharmacological agents or even needles. Thus, this
proposal is a critical step towards advancing the care of a large segment of IHD patients in the US.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Rohan Dharmakumar其他文献
Rohan Dharmakumar的其他文献
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{{ truncateString('Rohan Dharmakumar', 18)}}的其他基金
Mechanistic Insights to A Translatable Therapy for Acute Reperfused Hemorrhagic Myocardial Infarctions
急性再灌注出血性心肌梗塞可转化疗法的机制见解
- 批准号:
10359807 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Accurate, Needle-Free, MRI-based Detection of Ischemic Heart Disease without Contrast Agents
无需造影剂即可通过 MRI 进行准确、无针、基于 MRI 的缺血性心脏病检测
- 批准号:
10686342 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Mechanistic Insights to A Translatable Therapy for Acute Reperfused Hemorrhagic Myocardial Infarctions
急性再灌注出血性心肌梗塞可转化疗法的机制见解
- 批准号:
10630055 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Mechanistic Insights to A Translatable Therapy for Acute Reperfused Hemorrhagic Myocardial Infarctions
急性再灌注出血性心肌梗塞可转化疗法的机制见解
- 批准号:
9887771 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Accurate, Needle-Free, MRI-based Detection of Ischemic Heart Disease without Contrast Agents
无需造影剂即可通过 MRI 进行准确、无针、基于 MRI 的缺血性心脏病检测
- 批准号:
10201743 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Accurate, Needle-Free, MRI-based Detection of Ischemic Heart Disease without Contrast Agents
无需造影剂即可通过 MRI 进行准确、无针、基于 MRI 的缺血性心脏病检测
- 批准号:
10655692 - 财政年份:2020
- 资助金额:
$ 81.59万 - 项目类别:
Developing a MRI-guided Disease-Modifying Therapy for Post Infarction Chronic Heart Failure
开发 MRI 引导的梗死后慢性心力衰竭疾病缓解疗法
- 批准号:
9981537 - 财政年份:2017
- 资助金额:
$ 81.59万 - 项目类别:
Developing a MRI-guided Disease-Modifying Therapy for Post Infarction Chronic Heart Failure
开发 MRI 引导的梗死后慢性心力衰竭疾病缓解疗法
- 批准号:
9756228 - 财政年份:2017
- 资助金额:
$ 81.59万 - 项目类别:
4D SSFP MRI for Detecting Functionally Important Coronary Artery Stenosis at Rest
4D SSFP MRI 用于检测静息时具有重要功能的冠状动脉狭窄
- 批准号:
7837299 - 财政年份:2009
- 资助金额:
$ 81.59万 - 项目类别:
4D SSFP MRI for Detecting Functionally Important Coronary Artery Stenosis at Rest
4D SSFP MRI 用于检测静息时具有重要功能的冠状动脉狭窄
- 批准号:
8055423 - 财政年份:2008
- 资助金额:
$ 81.59万 - 项目类别:
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