Comprehensive Assessment of Right Ventricular and Pulmonary Vascular Function via CT Imaging in Heart Failure Patients

CT成像综合评估心力衰竭患者右心室和肺血管功能

• 批准号: 10603387
• 负责人: Francisco J Contijoch
• 金额: $ 6.98万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10603387
• 关键词: Area; Award; Biomedical Engineering; Blood Vessels; Cardiology; Collaborations; Coupling; Data Analyses; Data Collection; Destinations; Development; Evaluation; Fostering; Functional disorder; Heart Transplantation; Heart failure; Image; Impairment; Journals; Lung; Measurement; Measures; Mechanics; Mentors; Mentorship; Myocardial; Myocardium; Parents; Patient Care; Patients; Principal Investigator; Publications; Radiology Specialty; Research; Right ventricular structure; Risk; Techniques; Training; Training Activity; Training Support; Transplantation; Ventricular; Ventricular Function; Work; X-Ray Computed Tomography; base; clinical care; doctoral student; experience; functional disability; graduate student; heart function; improved; insight; left ventricular assist device; mechanical circulatory support; multidisciplinary; pressure; prognostic; right ventricular failure; symposium

Project Summary Parent Award: Mechanical circulatory support is required by a large percentage of patients who undergo heart transplant and serves as a destination therapy for end-stage heart failure patients who are ineligible for transplant. However, clinicians are currently unable to predict the up to 40% of patients who develop right heart failure after receiving left ventricular assist devices. This project aims to use CT to obtain load-independent measures of ventricular function and ventricular-arterial coupling to improve prediction of right heart function and failure in patients receiving left ventricular assist devices. Supplement: This supplement extends the utility of the CT imaging proposed in the parent award and supports the training and development of a bioengineering graduate student. Recent work has enabled robust mapping of regional dysfunction via new CT-based quantitative metrics. Specifically, we have combined regional strain measured via CT (RSCT) with RV pressure waveforms to estimate regional myocardial work (MW) as the area of the pressure-strain loop (MWCT). However, the utility of MWCT as an indicator of RV dysfunction in TOF patients has not been established. Therefore, we propose to determine whether the amount of myocardium with impaired MWCT better predicts functional impairment than RSCT and volume measurements. This work not only aims to improve prognostic evaluation but could also yield mechanistic insights into why the RV is at risk of failing. Importantly, this work seamlessly builds on the data collection and analysis efforts already underway as part of the parent award. In addition to this new research direction, the supplement outlines tailored training for a promising PhD student already being mentored by the principal investigator. Together, they have developed a set of training activities which will enable her to thrive at the interface of cardiology, radiology, and bioengineering. Specifically, she has fostered a collaboration with a cardiologist who will provide opportunities for her to shadow clinical care of patients and take part in multidisciplinary patient discussions. In addition, she has identified conferences, journals, and supplemental coursework which will provide her the networking, publication, and training experiences she needs to continue her work in this translational field.

项目摘要 家长奖：大部分患者需要机械循环支持， 接受心脏移植，并作为终末期心力衰竭患者的目的地治疗， 不适合移植然而，临床医生目前无法预测高达40%的患者， 在接受左心室辅助装置后出现右心衰竭。本项目旨在利用CT获得 心室功能和心室-动脉耦合的负荷无关性测量，以改善 预测接受左心室辅助装置的患者的右心功能和衰竭。 补充：本补充扩展了母合同中提出的CT成像的实用性， 支持生物工程研究生的培训和发展。最近的工作使强大的 通过新的基于CT的定量指标绘制区域功能障碍图。具体来说，我们结合了 通过CT（RSCT）测量的局部应变与RV压力波形，以估计局部心肌做功 (MW)压力-应变环（MWCT）的面积。然而，MWCT作为RV指标的实用性 TOF患者的功能障碍尚未确定。因此，我们建议确定 MWCT受损的心肌量比RSCT和体积更能预测功能障碍 测量.这项工作不仅旨在改善预后评估，但也可能产生机制， 为什么RV有失败的风险。重要的是，这项工作无缝地建立在数据收集和 分析工作已经在进行中，作为家长奖的一部分。 除了这个新的研究方向，补充概述了有前途的博士学位定制培训 学生已经由首席研究员指导。他们一起开发了一套训练方法 这些活动将使她能够在心脏病学，放射学和生物工程学的界面上茁壮成长。 具体来说，她与一位心脏病专家建立了合作关系，这位专家将为她提供机会， 跟踪患者的临床护理，并参与多学科患者讨论。此外，她还 确定会议，期刊，和补充课程，这将为她提供网络， 出版物，和培训经验，她需要继续她的工作在这个翻译领域。

项目成果

4D Flow Vorticity Visualization Predicts Regions of Quantitative Flow Inconsistency for Optimal Blood Flow Measurement.

4D 血流涡度可视化可预测定量血流不一致区域，以实现最佳血流测量。

• DOI: 10.1148/ryct.2020190054
• 发表时间: 2020
• 期刊: Radiology. Cardiothoracic imaging
• 作者: Contijoch,FranciscoJ;Horowitz,Michael;Masutani,Evan;Kligerman,Seth;Hsiao,Albert
• 通讯作者: Hsiao,Albert

Right Ventricular and Pulmonary Computed Tomography Assessments in Paradoxical Low-Flow Low-Gradient Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.

接受经导管主动脉瓣置换术的反常低流量低梯度主动脉瓣狭窄的右心室和肺部计算机断层扫描评估。

• DOI: 10.1016/j.shj.2022.100014
• 发表时间: 2022
• 期刊: Structural heart : the journal of the Heart Team
• 作者: Rigolli,Marzia;Reeves,Ryan;Smitson,Christopher;Yang,Jenny;Alotaibi,Mona;Mahmud,Ehtisham;Malhotra,Atul;Contijoch,Francisco
• 通讯作者: Contijoch,Francisco

Using a genetic risk score to calculate the optimal age for an individual to undergo coronary artery calcium screening.

• DOI: 10.1016/j.jcct.2019.05.005
• 发表时间: 2019-07
• 期刊: Journal of cardiovascular computed tomography
• 影响因子: 5.4
• 作者: L. Severance;F. Contijoch;H. Carter;C. Fan;T. Seibert;A. Dale;E. McVeigh

Myocardial Regional Shortening from 4D Cardiac CT Angiography for the Detection of Left Ventricular Segmental Wall Motion Abnormality.

4D 心脏 CT 血管造影的心肌区域缩短用于检测左心室节段性壁运动异常。

• DOI: 10.1148/ryct.220134
• 发表时间: 2023
• 期刊: Radiology. Cardiothoracic imaging
• 作者: Chen,Zhennong;Contijoch,Francisco;Kahn,AndrewM;Kligerman,Seth;Narayan,HariK;Manohar,Ashish;McVeigh,Elliot
• 通讯作者: McVeigh,Elliot

DiFiR-CT: Distance field representation to resolve motion artifacts in computed tomography.

• DOI: 10.1002/mp.16157
• 发表时间: 2023-03
• 期刊: MEDICAL PHYSICS
• 影响因子: 3.8
• 作者: Gupta, Kunal;Colvert, Brendan;Chen, Zhennong;Contijoch, Francisco
• 通讯作者: Contijoch, Francisco