Imaging of pulmonary arterial hypertension with proton MRI
质子 MRI 肺动脉高压成像
基本信息
- 批准号:10704305
- 负责人:
- 金额:$ 68.4万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-22 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AffectAgeBiological MarkersBlood VesselsBlood flowBreathingCardiacCardiac Catheterization ProceduresCessation of lifeClinicalClinical TrialsCombined Modality TherapyConsensusDataDevelopmentDiagnosisDiagnosticDiffuseDiseaseDisease ProgressionEnrollmentEventExerciseFailureGoalsGoldHeterogeneityHypoxiaImageImaging TechniquesInterventionLaboratoriesLaboratory FindingLungMagnetic Resonance ImagingMeasurementMeasuresMedicalMonitorMorphologic artifactsMotivationNewly DiagnosedNoisePathway interactionsPatientsPerfusionPharmacotherapyPhysiologicalPrediction of Response to TherapyProcessPrognosisProtocols documentationProtonsPublic HealthPulmonary CirculationPulmonary HypertensionRaceRegulationReportingReproducibilityResistanceSecondary toSeverity of illnessSignal TransductionSliceStructure of parenchyma of lungSurrogate EndpointTechniquesTestingTimeTranslatingTranslationsTransplantationVascular remodelingVentricularWalkingWorkarteriolecandidate markercardiac magnetic resonance imagingdata acquisitiondrug efficacyhealth goalsindexingindividual patientinhaled nitric oxideinnovationlung imaginglung volumemagnetic resonance imaging biomarkernovel therapeuticsoutcome predictionpatient biomarkersperfusion imagingpressureprognosticpulmonary arterial hypertensionpulmonary arterial pressurepulmonary vascular remodelingrespiratoryright ventricular failurescreeningsexsingle photon emission computed tomographysymposiumtooltreatment responseventilation
项目摘要
PROJECT SUMMARY
Goal/Significance. Pulmonary arterial hypertension (PAH) arises from progressive remodeling of the
pulmonary circulation leading to the secondary effects of elevated pulmonary arterial pressure and
resistance after 50% of vessels are affected. The leads to increased afterload, followed by right heart failure
and death. Improvement in medical therapy in PAH is related to the development of new drugs and
combination therapies rather than the identification of new pathways. This proposal meets a critical need
for tools that will better identify those who respond to these new therapies. The goal of this proposal is to
translate and refine biomarkers derived from proton magnetic resonance imaging (MRI), and evaluate their
sensitivity to predict disease progression in patients with PAH.
Scientific Premise. Functional proton MRI may provide increased sensitivity to disease progression because
of the ability to detect local changes related to vascular remodeling that is obscured by regions of normal
lung.
Innovation/Hypothesis. Building on our previous work developing innovative proton MRI biomarkers that are
markedly altered in patients with established PAH, we predict that the onset of PAH manifests as a
progressive alteration in images of the pulmonary circulation as follows: 1. an increase in un-perfused lung
regions as vessels succumb to remodeling 2. a resultant increase in the spatial heterogeneity of perfusion
and 3. an increase in fluctuations in perfusion reflecting a failure of local pressure regulation. Our selected
biomarkers reflect these processes. We hypothesize that these biomarkers are altered in patients with PAH,
with disease progression, by physiological changes induced by therapy and are early predictors of outcome.
Approach. Supported by our preliminary data we will: 1. Determine the sensitivity of proton MRI biomarkers
for patients with established PAH receiving therapy, evaluate biomarkers as a measures of disease severity
and compare these to clinical findings, and cardiac MRI (CMR) data. 2. optimize image acquisition protocol
efficiency to facilitate translation. Evaluate reproducibility, and effects of noise and artifacts. 3. Evaluate
proton MRI biomarkers as a means to monitor response to therapy by longitudinally monitoring newly
diagnosed PAH patients and assess the ability of lung biomarkers to predict time to clinical worsening
compared to CMR, and current standards.
Impact. Successful completion of this work will lead to new monitoring tools for patients with PAH using
noninvasive proton MRI, potentially providing prognostic information in patients with PAH. The techniques
proposed here could be ultimately conducted on any 1.5 T clinical MRI scanner in less than 30 minutes,
increasing utility for screening.
项目摘要
目标/意义。肺动脉高压(PAH)是由肺动脉高压的进行性重塑引起的。
肺循环导致肺动脉压升高的继发性影响,
当50%的血管受到影响时,导致后负荷增加,随后出现右心衰竭
与死PAH药物治疗的改善与新药的开发有关,
联合治疗,而不是识别新的途径。这一提议满足了一项迫切需要,
寻找能够更好地识别对这些新疗法有反应的人的工具。本提案的目的是
翻译和完善来自质子磁共振成像(MRI)的生物标志物,并评估其
预测PAH患者疾病进展的敏感性。
科学假设。功能性质子MRI可以增加对疾病进展的敏感性,
检测与血管重塑相关的局部变化的能力,这些变化被正常区域所掩盖,
肺。
创新/假设基于我们以前的工作,开发了创新的质子MRI生物标志物,
在已确诊的PAH患者中,肺动脉高压的发生率显著改变,我们预测PAH的发作表现为肺动脉高压,
肺循环图像的进行性改变如下:1.未灌注肺的增加
区域作为血管屈服于重塑2.灌注的空间异质性增加
和3.灌注波动的增加反映了局部压力调节的失败。我们选定的
生物标志物反映了这些过程。我们假设这些生物标志物在PAH患者中发生改变,
通过治疗引起的生理学变化与疾病进展相关,并且是结果的早期预测因子。
Approach.在我们的初步数据的支持下,我们将:1。确定质子MRI生物标志物的灵敏度
对于接受治疗的确诊PAH患者,评价生物标志物作为疾病严重程度的指标
并将其与临床结果和心脏MRI(CMR)数据进行比较。2.优化图像采集协议
提高翻译效率。评估再现性以及噪声和伪影的影响。3.评价
质子MRI生物标志物作为一种手段,通过纵向监测新的治疗反应,
诊断为PAH的患者,并评估肺部生物标志物预测至临床恶化时间的能力
与CMR和现行标准相比。
冲击这项工作的成功完成将为PAH患者带来新的监测工具,
无创质子MRI,可能为PAH患者提供预后信息。的技术
这里提出的最终可以在任何1.5T临床MRI扫描仪上在不到30分钟内进行,
增加了筛选的效用。
项目成果
期刊论文数量(1)
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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Susan R Hopkins其他文献
Susan R Hopkins的其他文献
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{{ truncateString('Susan R Hopkins', 18)}}的其他基金
Imaging Blood Flow, Ventilation, and Density Interactions
血流、通气和密度相互作用成像
- 批准号:
9103894 - 财政年份:2016
- 资助金额:
$ 68.4万 - 项目类别:
Imaging Hypoxic Pulmonary Vasoconstriction in the Aging Lung with Proton MRI
使用质子 MRI 对老化肺部的缺氧性肺血管收缩进行成像
- 批准号:
9000558 - 财政年份:2016
- 资助金额:
$ 68.4万 - 项目类别:
Imaging Hypoxic Pulmonary Vasoconstriction in the Aging Lung with Proton MRI
使用质子 MRI 对老化肺部的缺氧性肺血管收缩进行成像
- 批准号:
9330913 - 财政年份:2016
- 资助金额:
$ 68.4万 - 项目类别:
Imaging Nonlinear Control of the Pulmonary Circulation with Proton MRI
质子 MRI 肺循环的成像非线性控制
- 批准号:
8721484 - 财政年份:2013
- 资助金额:
$ 68.4万 - 项目类别:
Imaging Nonlinear Control of the Pulmonary Circulation with Proton MRI
质子 MRI 肺循环的成像非线性控制
- 批准号:
8582165 - 财政年份:2013
- 资助金额:
$ 68.4万 - 项目类别:
Lung Perfusion Heterogeneity and Mechanisms of Edema
肺灌注异质性和水肿机制
- 批准号:
7102554 - 财政年份:2006
- 资助金额:
$ 68.4万 - 项目类别:
Lung Perfusion Heterogeneity and Mechanisms of Edema
肺灌注异质性和水肿机制
- 批准号:
7577428 - 财政年份:2006
- 资助金额:
$ 68.4万 - 项目类别:
Lung Perfusion Heterogeneity and Mechanisms of Edema
肺灌注异质性和水肿机制
- 批准号:
7194180 - 财政年份:2006
- 资助金额:
$ 68.4万 - 项目类别:
Lung Perfusion Heterogeneity and Mechanisms of Edema
肺灌注异质性和水肿机制
- 批准号:
7781303 - 财政年份:2006
- 资助金额:
$ 68.4万 - 项目类别:
Lung Perfusion Heterogeneity and Mechanisms of Edema
肺灌注异质性和水肿机制
- 批准号:
7385875 - 财政年份:2006
- 资助金额:
$ 68.4万 - 项目类别:
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