. Despite improvements in therapies targeted at reducing disease burden, CAD continues to afflict >16 million US adults, accounting for more than 1/3 of all deaths and responsible for ~1.2 million hospitalizations annually. Coronary revascularization remains a mainstay of treatment for CAD, with >1.2 million percutaneous interventions performed annually in the US. Prior multicenter trials have demonstrated propitious outcomes for individuals with who undergo ischemia-guided revascularization by fractional flow reserve (FFR)?an invasive ?gold? standard that determines the physiologic significance of coronary stenoses. More recently we have studied the accuracy of a non-invasive CT-based alternative to FFR, termed FFRCT. While this new method is moderately accurate, it possesses several limitations such as assuming the walls of the coronaries are rigid and flow is non-pulsatile. Therefore, we have determined an alternative approach to assessing coronary hemodynamics via 3D printing, which allows physical measurements of coronary flow using realistic tissue mechanics and pulsatile flow. In this application, we will optimize the hardware, software, workflows, and analysis to build and evaluate coronary hemodynamics based on patient CT images. Extensive clinical imaging data, including 15O-H2O labeled PET imaging will be used to validate the accuracy of these models for predicting coronary hemodynamics. Finally, these 3D printed models will be used to develop clinically useful reports that can provide diagnostic determination of a patient's level of ischemia using only non-invasive CT imaging.

Public Health Relevance

. The goal of this proposal is to build and optimize the equipment, software, workflows and analysis to create anatomically accurate 3D print coronary flow models with realistic tissue mechanics. Extensive clinical data will be leveraged to validate these 3D printed coronary models against patient measurement and images, such that the anatomic and hemodynamic factors are all properly recapitulated. Finally, results from these 3D printed models will be used to develop clinically useful reports that can provide diagnostic determination of a patient's level of ischemia using only non-invasive CT imaging.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL118019-07
Application #
9926910
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Fleg, Jerome L
Project Start
2013-09-01
Project End
2023-04-30
Budget Start
2020-05-01
Budget End
2021-04-30
Support Year
7
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Weill Medical College of Cornell University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
060217502
City
New York
State
NY
Country
United States
Zip Code
10065
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