Most prominent of the NHLBI awards is an $868,000 Vascular Interventions/Innovations and Therapeutic Advances contract presented to Raymond L. Benza, MD, Director of the Advanced Heart Failure, Transplantation, Mechanical Circulatory Support and Pulmonary Hypertension Program at AGH for his proposal, “A study to explore the feasibility of using combined modalities to test the safety of CardioMEMS device in PAH patients.”
The prestigious contract is among only six awarded to university and industry-based investigative teams in the country this year from a field of 40 applicants.
Dr. Benza along with co-investigators Robert Biederman, MD and Mark Doyle, PhD, envision using the CardioMEMS pulmonary artery hemodynamic monitoring system coupled with cardiac MRI for the purpose of managing patients with severe pulmonary arterial hypertension.
“Pulmonary arterial hypertension is a life-threatening condition with no cure,” Dr. Benza said. “We’re very pleased to be able to devote significant resources to clinical trials designed to zero in on better ways to manage the condition to extend life and improve quality of life for our patients.”
Pulmonary arterial hypertension (PAH) is caused by changes in the cells of the artery leading to the lungs that cause it to narrow.
The narrowed artery can’t support adequate blood flow, prompting the heart to pump harder to try to move more blood to the lungs. PAH can cause the right side of the heart to become weakened and enlarged and can eventually lead to heart failure.
CardioMEMS is a wireless, battery-less system implanted into the pulmonary artery via catheter to allow physicians to measure a patients’ pulmonary artery pressure remotely from home.
Cardiac MRI uses powerful magnets to provide computer generated three-dimensional images of the heart and arteries, providing high-resolution pictures of the heart’s chambers and vessels non-invasively and without the need for radioactive contrast agents. Advanced cardiac MRI tools and analytics show promise in helping cardiologists better understand the contractile properties of the right ventricle.
Combining the two techniques could provide a more complete picture of the patient’s heart health and ultimately could help to improve the quality of life for patients with PAH, Dr. Benza said.
“If validated, this approach would be preferable to the typical, more invasive, approach of repetitive cardiac catheterizations,” according to Dr. Biederman, Director of AGH’s Cardiac MRI Center. “A non-invasive approach that facilitates earlier therapeutic intervention can lead to wholesale changes in the manner in which PAH patients are treated and result in fewer hospitalizations and deaths.”
The Cardiovascular Institute at AGH, in collaboration with Pittsburgh-based software company BlenderHouse and the biomedical engineering department at Carnegie Mellon University (CMU), also was the recipient of a second grant from the NHLBI for the development of a Cardiac Health Risk Stratification System.
Principal investigators Srinivas Murali, MD and Manreet Kanwar, MD were awarded a $150,000 Small Business Technology Transfer grant to produce and beta test a clinical decision support application for assessing patients with advanced heart failure who may become candidates for left ventricular assist device (LVAD) support.
“The goal of this project is to create a tool to provide accurate, personalized prognoses for patients being considered for an LVAD,” said Dr. Murali, Medical Director of the Allegheny Health Network Cardiovascular Institute.
The CHRiSS: Cardiac Health Risk Stratification System will be built upon existing machine learning and data mining technology, developed by CMU to predict 90-day mortality following VAD implantation. Incorporating sophisticated statistical analyses, the new tool aims to better predict adverse cardiac events and pinpoint risk of hospital readmission.
“Current risk stratification tools are simply inadequate in predicting outcomes reliably in patients receiving LVAD therapy,” said Dr. Kanwar, an Allegheny General cardiologist specializing in heart failure. “We need better tools to help clinicians make the best possible use of potentially life-saving technology while providing cost-effective care.”
The CHRiSS study is being done in collaboration with Natasha Loghmanpour, MS and James F. Antaki, PhD, from CMU and Michael Cham from BlenderHouse.
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