Brad Leshnower will apply NIH/NHLBI grant to develop predictive model for UTABD treatment strategy
The National Institutes of Health and the National Heart, Lung, and Blood Institute have awarded Brad Leshnower, MD, an R01 grant to study risk stratification of uncomplicated type B aortic dissection (UTABD) using clinical and engineering analysis.
The primary objective of the project is to develop a novel, personalized machine-learning model for predicting those patients with acute UTABD — a tear in the aorta distal to the left subclavian artery without rupture or concomitant organ malperfusion — that would most likely fail optimal medical therapy and benefit instead from endovascular treatment.
The design and creation of the model will be aided by the biomechanical engineering expertise of Rudy Gleason, PhD, a Georgia Institute of Technology scientist and expert in cardiovascular mechanics and tissue growth, remodeling, and engineering. Dr. Gleason oversees the Tissue Mechanics Lab at Georgia Tech, which will be performing extensive biomechanical testing on aortic tissue from the Emory Aortic Tissue Bank and sophisticated structural modeling of the aorta based upon CT scans of patients with UTBAD.
A large database of patients with type B aortic dissection treated by Dr. Leshnower at the Emory Aortic Center will provide the risk factors that will be key components of the model. Demographics, clinically relevant predispositions, anatomic shape features, aortic tissue mechanics, the fluid-structure interaction (FSI) method, and machine learning techniques will then be incorporated to determine the risk potential for the formation of false lumen aneurysm and the likelihood of a catastrophic aortic event.
"The ability to develop accurate tear and rupture metrics from aortic specimens drawn from our own patient database is one of the unique aspects of this model," says Dr. Leshnower, who also codirects the Aortic Center. "Once the model is validated, we will begin prospective testing."
A cohort assembled from patients presenting at the Aortic Center with a new diagnosis of acute UTABD will then receive 4D flow MRI performed by John Oshinski, PhD, director of Emory's Center for Systems Imaging Core. After the resulting data is examined and evaluated by the model, its predictive reliability will be evaluated.
Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL155537. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.