Project details

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Right ventricular adaptation in children with pulmonary arterial hypertension [copy]

Keywords:
children pulmonary hypertension Right ventricular failure

Researchers:
prof. dr. R.M.F. Berger
dhr JM (Menno) Douwes
dhr SJB (Sander) Schomaker
CA (Cristóbal) Bertoglio

Type of project:
Stage Wetenschap / Research project

Nature of the research:
During this project you will learn the basics of cardiovascular physiology and experience the basic concepts of computational modelling. You will become familiar with paediatric pulmonary arterial hypertension and right ventricular failure. The goal of this project is to apply am existing computational model to individual clinical patient data. Using hemodynamic (catheterization) and MRI measurements of children with PAH, that are seen at the National Referral Center for Paediatric PAH at the UMCG, we will characterize the pattern of right ventricular adaptation and ventricular vascular coupling in children with PAH. Furthermore we will analyse the association between ventricular vascular coupling parameters and the patients survival.

Fields of study:
pediatrics medical physiology cardiology

Background / introduction
Pulmonary arterial hypertension (PAH) is a progressive pulmonary vascular disease characterized by increased pulmonary vascular resistance and a reduction in pulmonary arterial compliance. This leads to an increased workload of the right ventricle (RV). In children with PAH the RV can at first adapt to this increased workload. But eventually RV adaptation progresses to RV failure and the patient dies.
The coupling between the pulmonary circulation and the pattern and progression of right ventricular adaptation and failure are still poorly understood. This makes it difficult to monitor the patients disease progression and identify in which patients right ventricular failure is imminent.
We have developed a computational model of the pulmonary circulation that, based on individual hemodynamic and MRI measurements, is able to better characterize right ventricular adaptation and ventricular vascular coupling.
Research question / problem definition
The goal of this project is to apply the computational model to clinical patient data. Using the hemodynamic and MRI measurements of children with PAH that are seen at the National Referral Center for Paediatric PAH at the UMCG, we will characterize the pattern of right ventricular adaptation and ventricular vascular coupling in children with PAH. Furthermore we will analyse the association between ventricular vascular coupling parameters and the patients survival.

Questions:
1 Can we identify the pattern of right ventricular adaptation and ventricular vascular coupling in children with PAH using a computational model
2 Can we use parameters of right ventricular adaptation and ventricular vascular coupling to predict survival in children with PAH
Workplan
1. Collect and prepare hemodynamic and MRI data from children with PAH identified from our national registry for children with PAH.
2. Analyse the hemodynamic and MRI data with the computational model to produce parameters of right ventricular adaptation and ventricular vascular coupling (experience with computational modelling not strictly required).
3. Statistical analyses to study the association between the parameters produced by the model and the patients disease severity and outcome.
References
[1] D. Montani, S. Gunther, Dorfmuller, and P. et al. “Pulmonary arterial hypertension.” In: Orphanet J Rare Dis 8 (97 2013).
[2] J. Douwes. “Shaping the future of paediatric pulmonary arterial hypertension.” In: Rijksuniversiteit Groningen (2017).
[3] G. Kovacs, Z. Katerina, and et al. “Clinical Impact of the New Definition of Precapillary Pulmonary Hypertension.” In: Chest 159 (5 May 2021), pp. 1995–1997.
[4] M. Hoeper, M. Humbert, R. Souza, M. Idrees, S. Kawut, K. Sliwa-Hahnle, Z. Jing, and J. Gibbs. “A global view of pulmonary hypertension..” In: The Lancet. Respiratory medicine 4.4 (2016), pp. 306–322.
[5] L. Gu, Y. Li, L. Gu, L. Xie, and H. Liu. “ Idiopathic Pulmonary Arterial Hypertension and Pulmonary Arterial Hypertension Associated With Congenital Heart Disease in Chinese Children: Similarities, Differences, and Prognostic Factors.” In: Front Pediatr 8 (), p. 106.
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