Myocardial Radiomics and Mechanics in the Pathology and Prognosis of Cardiovascular Disease

心肌放射组学和力学在心血管疾病病理学和预后中的应用

• 批准号: 10576870
• 负责人: Connie Tsao
• 金额: $ 84.49万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576870
• 关键词: Adult; African American; African American population; Aging; Atrial Fibrillation; Biological; Biological Markers; Biology; Blood; Cardiomyopathies; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cessation of life; Chemosensitization; Clinical; Communities; Complex; Comprehension; Computing Methodologies; Coronary Arteriosclerosis; Coronary Artery Ischemia; Data; Detection; Development; Dilated Cardiomyopathy; Dimensions; Disease; EFRAC; Early Diagnosis; Early identification; Evaluation; Functional disorder; Future; General Population; Genetic; Genotype; Goals; Health; Heart failure; High Prevalence; Hypertrophic Cardiomyopathy; Hypertrophy; Image; Image Analysis; Individual; Inflammation; Intervention; Jackson Heart Study; Joints; Knowledge; Left Ventricular Remodeling; Left ventricular structure; Machine Learning; Magnetic Resonance; Magnetic Resonance Imaging; Mathematics; Measures; Mechanics; Methods; Morbidity - disease rate; Myocardial; Myocardial dysfunction; Myocardium; Obesity; Outcome; Outcome Measure; Participant; Pathogenesis; Pathologic; Pathology; Pathway interactions; Patient Care; Pattern; Phenotype; Population; Prevalence; Prevention; Prognosis; Race; Radiogenomics; Risk; Risk Factors; Role; Serum; Shapes; Single Nucleotide Polymorphism; Source; Statistical Models; Structure; Technology; Texture; Torsion; Ventricular Remodeling; Woman; advanced disease; adverse outcome; biracial; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular imaging; cardiovascular risk factor; caucasian American; cohort; disease phenotype; follow-up; genetic variant; genome sequencing; heart function; human old age (65+); hypertensive heart disease; improved; innovation; insight; ischemic cardiomyopathy; mortality; novel; polygenic risk score; preservation; prognostic value; quantitative imaging; radiomics; risk stratification; secondary analysis; sex; therapy development; treatment risk; trend; whole genome

PROJECT SUMMARY Though knowledge advances have been made in identification and treatment of risk factors, cardiovascular disease (CVD) remains the leading cause of death in the U.S., and has been worldwide for the past 15 years. The mechanisms of three leading sources of CVD morbidity, ischemic coronary artery disease, heart failure, and atrial fibrillation, appear rooted in myocardial pathophysiology of the left ventricle (LV), suggesting that deeper phenotyping of the LV may provide insight into the diseases. The detection of earliest forms of LV dysfunction has been challenging: traditional measures of LV structure and function associated with poor outcomes, such as mass and ejection fraction, reflect advanced stages of disease. However, recent advances in quantitative imaging of the LV myocardium using cardiovascular magnetic resonance (CMR) images may bridge this gap. Myocardial texture analysis is a type of ‘radiomics’, the computation of myocardial pixel intensity and patterns, which has shown the ability to differentiate pathological patterns in LV hypertrophy. Additionally, analysis of myocardial mechanics including strain and torsion have shown prognostic value in evaluation of cardiomyopathies. Thus, increasing evidence indicates roles for these technological advances in imaging analysis to evaluate pathological LV remodeling in subclinical cardiovascular disease in the general population. We hypothesize that application of these novel imaging analytics, correlated with biology, subclinical disease phenotyping, and outcomes, will enable more granular insight into subclinical LV structural and functional changes predating overt CVD and its forms. The Framingham and Jackson Heart Studies, community-based cohorts of whites and African Americans with longitudinal follow up, offer the opportunity to gain insight in CVD development through integration of advanced secondary imaging analysis with detailed and broad phenotyping and genotyping, and clinical end-points. Thus, the objectives of our proposal are threefold: 1) to first identify myocardial texture analysis and mechanics patterns associated with prevalent CVD and risk factors, 2) to define the biological and genetic underpinnings of these phenotypes, and 3) to understand their inter-association between structure and function, and their joint relations with long-term prognosis. Execution of our Aims will elucidate novel patterns, determinants, and prognosis of underlying early and progressive myocardial remodeling and dysfunction in CVD in a large bi-racial cohort. Ultimately, our goal is for knowledge gained from this study to advance phenotyping of LV remodeling groups, methods of cardiovascular risk stratification, and development of therapies for patient care.

项目摘要 虽然在识别和治疗危险因素方面取得了知识进步，但心血管疾病 疾病（CVD）仍然是美国的主要死亡原因，在过去的15年里， 缺血性冠状动脉疾病、心力衰竭， 和心房颤动，似乎植根于左心室（LV）的心肌病理生理学，这表明， LV的更深的表型分析可以提供对疾病的了解。早期LV的检测 功能障碍具有挑战性：传统的左心室结构和功能测量与不良 诸如质量和射血分数的结果反映了疾病的晚期。然而，最近的进展 在使用心血管磁共振（CMR）图像的LV心肌的定量成像中， 弥合这一差距。心肌纹理分析是放射学的一种， 强度和模式，这表明有能力区分LV肥大的病理模式。 此外，包括应变和扭转在内的心肌力学分析显示了对心肌缺血的预后价值。 评价心肌病。因此，越来越多的证据表明，这些技术进步的作用， 影像学分析评价亚临床心血管疾病的病理性左室重构 人口我们假设，这些新的成像分析的应用，与生物学， 亚临床疾病表型和结局，将使亚临床LV结构的更细粒度的见解， 以及早于明显CVD及其形式的功能变化。弗雷泽和杰克逊心脏研究， 以社区为基础的白人和非裔美国人队列，并进行纵向随访， 通过将先进的二次成像分析与详细的 以及广泛的表型和基因分型以及临床终点。因此，我们建议的目标是 三方面：1）首先识别与普遍CVD相关的心肌纹理分析和力学模式 和风险因素，2）确定这些表型的生物学和遗传学基础，以及3） 了解它们的结构和功能之间的相互关联，以及它们与长期 预后执行我们的目标将阐明新的模式，决定因素和预后的潜在早期 和进行性心肌重塑和功能障碍的心血管疾病在一个大的双种族队列。最终，我们的目标 是为了从这项研究中获得的知识，以推进LV重塑组的表型， 心血管风险分层和患者护理治疗的发展。