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Early Detection of Vascular Dysfunction Using Biomarkers from Lagrangian Carotid Strain Imaging

使用拉格朗日颈动脉应变成像生物标志物早期检测血管功能障碍

基本信息

批准号：
10653121
负责人：
TOMY VARGHESE
金额：
$ 58.49万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
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：
2020-07-15 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10653121
关键词：
3-Dimensional Age Age Years Aging Algorithms Arterial Fatty Streak Arteries Atherosclerosis Biochemical Biological Markers Blood Blood Pressure Blood Vessels Blood flow Cardiac Carotid Arteries Carotid Endarterectomy Cerebrovascular system Characteristics Classification Clinical Code Cognition Color Deposition Development Disease Early Diagnosis Embolism Fostering Frequencies General Population Goals Grant Guidelines Histopathology Human Volunteers Hyperlipidemia Hypertension Image Individual Intervention Lateral Life Style Modification Location Longitudinal Studies Magnetic Resonance Imaging Measurement Measures Medical Methods Modulus Noise Pathologic Patients Performance Physiological Population Populations at Risk Predisposition Protocols documentation Research Risk Rupture Scanning Screening procedure Sequoia Severities Signal Transduction Stenosis Stream Stress Stroke Structure Subgroup System Therapeutic Embolization Time Tissues Ulcer Ultrasonography Validation Variant Vascular Cognitive Impairment Vascular Diseases Work age group age related clinical imaging clinically significant cost feeding high risk population human data human subject imaging approach imaging study improved in vivo indexing innovation interest mechanical properties novel novel strategies plaque lesion pressure reconstruction response screening trend ultrasound vascular risk factor volunteer

项目摘要

Abstract Current clinical criteria for treatment of atherosclerotic plaque, or atheromas, have focused primarily on percent stenosis of the vessel. However, measures of occlusion (percent stenosis) do not identify those plaques that are prone to rupture, which may release emboli into the blood stream feeding sensitive cerebral vasculature. A novel approach, Lagrangian carotid strain imaging, where tissue displacements are precisely measured during pulsation of blood through the artery has been developed. We propose to measure `strain indices,' that include the maximum accumulated axial, lateral, and shear strain estimated over the cardiac cycle, to probe the detailed mechanical properties of early plaque. We believe these strain indices will prove to be valuable vascular biomarkers to indicate vascular aging and possible plaque vulnerability. Our preliminary results demonstrate the ability to differentiate between soft and stiff regions in plaque under in-vivo clinical imaging conditions. Our definition of `vulnerable plaque' or `vulnerable patient' relies on the identification of lipidic depositions or softer plaques, i.e., those that undergo large axial or lateral deformations and/or large shearing strains during the cardiac cycle. Capability of strain tensor imaging and vascular biomarkers to characterize plaque severity from its early stages to a mature plaque lesion will be evaluated and quantified. A study on asymptomatic volunteers and patients also is proposed. The volunteer will provide values for vascular strain indices normalized to age-related vascular stiffening. The results will enable us to establish trends in age-related variations in vascular stiffness and to determine deviations that could establish vascular aging criteria. Interventions to reverse vascular aging might then be used, for example lifestyle modifications and common medical therapies. Strain imaging results will be validated and complimented by three- dimensional (3D) carotid magnetic resonance imaging (MRI) on a selected group of high-risk volunteers, along with 3D carotid MRI and 3D histopathological analysis of the entire excised plaque on patients to better understand plaque composition and structure. Validation of our results will foster use of real-time noninvasive ultrasound strain imaging as a screening tool for identifying human subjects susceptible to vascular aging and/or developing plaque prone to rupture or micro-embolization that could lead to `silent strokes' and possible vascular cognitive impairment. The patient study will also enable comparison of strain indices and carotid MRI to the ground truth, namely the excised plaque.

摘要目前治疗动脉粥样硬化斑块或动脉粥样硬化的临床标准主要集中在血管狭窄的百分比。然而，闭塞的测量(狭窄百分比)并不能确定容易破裂的斑块，可能会释放栓子进入供血敏感的大脑脉管系统。一种新的方法，拉格朗日颈动脉应变成像，其中组织位移精确地在通过动脉的血液搏动过程中测量的数据已经被开发出来。我们建议测量‘应变’ 指数，包括估计的心脏的最大轴向、侧向和剪切应变循环，探讨早期斑块的详细力学性质。我们相信这些应变指数将证明是指示血管老化和可能的斑块脆弱性的有价值的血管生物标志物。我们的初步结果显示了区分斑块软硬区的能力。在体内的临床成像条件下。我们对‘脆弱斑块’或‘脆弱患者’的定义依赖于识别脂质沉积或较软的斑块，即那些经历大的轴向或侧向的斑块心动周期期间的变形和/或大的剪切应变。应变张量成像能力和从斑块早期阶段到成熟斑块病变特征的血管生物标志物将是评估和量化。还提出了一项针对无症状志愿者和患者的研究。志愿者将提供价值对于与年龄相关的血管硬化归一化的血管应变指数。结果将使我们能够确定血管硬度与年龄相关的变化趋势，并确定可能建立血管的偏差老化标准。然后可以使用逆转血管老化的干预措施，例如改变生活方式以及常见的医学疗法。应变成像结果将由三个人验证和赞扬- 选择一组高危志愿者的三维(3D)颈动脉磁共振成像(MRI) 用3D颈动脉MRI和3D组织病理学分析对患者切除的整个斑块进行更好的了解斑块的组成和结构。对我们结果的验证将促进实时非侵入性超声应变成像作为筛选工具识别易受血管老化影响的受试者和/或形成容易破裂的斑块或微栓塞术，这可能导致“无症状性卒中”和血管认知障碍。患者研究还将使应变指数与颈动脉MRI进行比较真相，也就是切除的斑块。