The development of atherosclerotic coronary artery disease is complex. Recent work indicates that plaque progression and risk of clinical events are influenced by plaque morphology and composition, local hemodynamic stresses, 3-D arterial motion, inflammation, and local vascular signaling. In Phase I of this proposal, we developed a method for 3-D and 4-D assessment of coronary artery morphology and hemodynamics by fusion of angiographic and intravascular ultrasound images. In Phase II, we will develop a method for predicting atherosclerosis progression. This predictive model, incorporating our now mature methodology with other factors, will be developed and subsequently validated in longitudinal studies of subjects with coronary atherosclerotic disease. Our main hypothesis is that serial in-vivo studies of patients with coronary artery disease can provide insights into the temporal effects of vessel morphology, plaque composition, hemodynamics, and systemic inflammatory and other vascular biomarkers on local atherosclerosis progression, thus allowing the prediction of changes in the burden, location and extent of atherosclerosis. Therefore, we propose to:
Aim 1 : Further improve the previously developed image analysis methodology for angiography-IVUS fusion to increase efficiency, reproducibility, and 3-D/4-D consistency of the geometric representations of coronary arteries in vivo.
Aim 2 : Develop a method for in vivo 3-D and 4-D assessment of complex plaque composition in registration with geometrically correct coronary anatomy and plaque morphology with the ability to incorporate functional and physiologic measures within the vasculature.
Aim 3 : Develop a method for predicting temporal changes in atherosclerotic plaque in vivo from multifactorial computational assessment of 3-D and 4-D coronary geometry, hemodynamics, plaque morphology and composition, with the concomitant determination of systemic atherosclerosis-related biomarkers.
Aim 4 : Validate the plaque progression prediction method in a serial study of 50 patients with established atherosclerosis. Our work will uncover the relative contribution of initial local plaque properties and composition, the vascular and systemic inflammatory milieu and hemodynamic conditions to intermediate-term atherosclerotic disease progression or regression. Once successfully developed, our work will uncover the interplay of these complex and disparate promoters of atherosclerosis. It will have implications on the clinical management of patients with preclinical atherosclerotic disease as well as those patients undergoing coronary revascularization and treatment of acute coronary syndromes.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL063373-07
Application #
7326811
Study Section
Special Emphasis Panel (ZRG1-CICS (01))
Program Officer
Goldberg, Suzanne H
Project Start
1999-09-15
Project End
2009-11-30
Budget Start
2007-12-01
Budget End
2008-11-30
Support Year
7
Fiscal Year
2008
Total Cost
$322,251
Indirect Cost
Name
University of Iowa
Department
Engineering (All Types)
Type
Schools of Engineering
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Zhang, Ling; Wahle, Andreas; Chen, Zhi et al. (2018) Predicting Locations of High-Risk Plaques in Coronary Arteries in Patients Receiving Statin Therapy. IEEE Trans Med Imaging 37:151-161
Kovarnik, Tomas; Chen, Zhi; Mintz, Gary S et al. (2017) Plaque volume and plaque risk profile in diabetic vs. non-diabetic patients undergoing lipid-lowering therapy: a study based on 3D intravascular ultrasound and virtual histology. Cardiovasc Diabetol 16:156
Kovarnik, Tomas; Jerabek, Stepan; Chen, Zhi et al. (2016) Non-invasive endothelial function assessment using digital reactive hyperaemia correlates with three-dimensional intravascular ultrasound and virtual histology-derived plaque volume and plaque phenotype. Kardiol Pol 74:1485-1491
Hirai, Taishi; Chen, Zhi; Zhang, Ling et al. (2016) Evaluation of Variable Thin-Cap Fibroatheroma Definitions and Association of Virtual Histology-Intravascular Ultrasound Findings With Cavity Rupture Size. Am J Cardiol 118:162-9
Zhang, Ling; Wahle, Andreas; Chen, Zhi et al. (2015) Simultaneous Registration of Location and Orientation in Intravascular Ultrasound Pullbacks Pairs Via 3D Graph-Based Optimization. IEEE Trans Med Imaging 34:2550-61
Balocco, Simone; Gatta, Carlo; Ciompi, Francesco et al. (2014) Standardized evaluation methodology and reference database for evaluating IVUS image segmentation. Comput Med Imaging Graph 38:70-90
Kovarnik, Tomas; Kral, Ales; Skalicka, Hana et al. (2013) The prediction of coronary artery disease based on non-invasive examinations and heme oxygenase 1 polymorphism versus virtual histology. J Invasive Cardiol 25:32-7
Kovarnik, T; Kral, A; Skalicka, H et al. (2013) Prediction of coronary vessel involvement on the basis of atherosclerosis risk factor analysis. Bratisl Lek Listy 114:413-7
Sun, Shanhui; Sonka, Milan; Beichel, Reinhard R (2013) Graph-based IVUS segmentation with efficient computer-aided refinement. IEEE Trans Med Imaging 32:1536-49
Kovarnik, Tomas; Mintz, Gary S; Skalicka, Hana et al. (2012) Virtual histology evaluation of atherosclerosis regression during atorvastatin and ezetimibe administration: HEAVEN study. Circ J 76:176-83

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