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

项目摘要 家长奖：大部分符合以下条件的患者需要机械循环支持 接受心脏移植，作为终末期心力衰竭患者的目的地治疗 没有资格进行移植。然而，临床医生目前无法预测高达40%的患者 接受左心辅助装置后出现右心衰竭。该项目旨在使用CT来获取 改善心功能和室动脉偶联的负荷非依赖性措施 接受左心辅助装置的患者右心功能和衰竭的预测。 补充：本补充内容扩展了父母奖中提出的CT成像的用途，并 支持生物工程研究生的培养和发展。最近的工作使健壮的 通过新的基于CT的量化指标绘制区域功能障碍图。具体地说，我们已经联合 利用右室压力波形通过CT(RSCT)测量局部应变来估计局部心肌作功 (MW)作为压力-应变回路(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，我们建议确定是否 MWCT受损的心肌量比RSCT和容量更能预测功能损害 测量。这项工作不仅旨在改善预后评估，而且还可能产生机械性的 洞察为什么房车有失败的风险。重要的是，这项工作无缝地建立在数据收集和 作为家长奖的一部分，分析工作已经在进行中。 除了这个新的研究方向，副刊还概述了为有前途的博士量身定做的培训 学生已经得到了首席调查员的指导。他们一起制定了一套培训方案 这些活动将使她在心脏病学、放射学和生物工程的交汇点上茁壮成长。 具体地说，她与一位心脏病专家建立了合作关系，后者将为她提供机会 跟踪患者的临床护理，参与多学科的患者讨论。此外，她还拥有 确定的会议、期刊和补充课程将为她提供网络， 她需要出版和培训经验，以继续她在翻译领域的工作。

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.