A new, multimillion-dollar grant awarded to the University of Colorado by the National Institutes of Health for the study of pulmonary hypertension in children will include the creation of 200 patient-specific computer models that will be used to help refine diagnosis and improve treatment of the life-threatening disease.
CU-Boulder mechanical engineering Professor Robin Shandas will lead development of the individualized models, which will be based on three-dimensional imaging combined with computational modeling of the blood flow and mechanics of the pulmonary vascular systems in infants and children.
Shandas has been a member of the CU faculty since 1995 and has directed the NIH Graduate Training Program in Cardiovascular Biomechanics and Imaging since 2003. He splits his time between the Boulder campus and the University of Colorado at Denver and Health Sciences Center's School of Medicine, where he has a joint appointment in pediatric cardiology and works closely with clinicians at The Children's Hospital.
The NIH grant, which is expected to be funded at between $12 million and $14 million over a five-year period, involves five primary investigators who will use a combination of basic science, bioengineering and clinical research approaches to improve understanding of pulmonary hypertension. Shandas is unique among the investigators in bringing a bioengineering approach to the research.
The research is part of NIH's Specialized Centers of Clinically Oriented Research program, which is aimed at translating basic research into the clinical arena to enable research findings to be more rapidly applied to treating patients.
Pulmonary hypertension is a condition characterized by high blood pressure in the arteries that supply blood to the lungs. Breathing disorders such as emphysema and bronchitis can lead to pulmonary hypertension, but in children the condition is often the result of congenital heart disease. Various drugs can be used to treat the condition, while the most severe cases are recommended for heart or lung transplants.
Patient-specific simulations that model the blood flow and biomechanics of the pulmonary vascular system need to be developed to improve diagnostic capability and refine treatments since each patient's anatomy is different, Shandas said.
"The blood flow impacts arterial motion and deformation, and vice versa," he said. "The simulations will provide doctors with an amazing level of detail that will help them make the most accurate diagnoses and fine-tune treatments.
"One of the challenges is to reduce the time taken to produce the simulation for each patient," he added. "Currently, this takes approximately 40 hours. We would like to reduce it to under 8 hours, which would allow overnight delivery of the results to the clinician.
"We're interested in getting clinically useful information that can be used to help patients," he said. "Patients who participate in the study will be followed for a one-year period to determine the extent of their improvement."
Shandas will collaborate with Dr. Dunbar Ivy, chief of cardiology and director of the Pediatric Pulmonary Hypertension Program at The Children's Hospital, and his findings will be combined with those of the other primary investigators to create a broader understanding of the disease.
Shandas also received a Mid-Career Award from NIH that will provide an additional $700,000 over five years for training of physicians and doctoral students in his area of research.