Showing 3 ideas for tag "dissection"

Goal 2: Reduce Human Disease

Detection of rupture prone small aortic aneurysms

Critical challenges in the assessment of aortic aneurysms are: (1) Availability of reliable animal models that simulate the human pathology, (2) Availability of molecular imaging resources – identification of biomarkers, development of targeted imaging probes and pre-clinical imaging methods, and plasma markers that predict whether an aneurysm is prone to rupture or dissection, (3) Bringing together a wide array of multi-disciplinary... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Developing clinically viable methods to detect rupture prone aneurysms can lead to better methods of diagnosis and intervention and avoid preventable fatalities

Feasibility and challenges of addressing this CQ or CC

Several other disease areas including oncological that had similar gap was filled by NIH (NCI) and the challenges were overcome in less than 10 years. The scientific expertise to fill the gap exists, however they work in silos, which need to be brought together to fulfil this gap and is achievable in less than 10 years
Assessment of aortic aneurysms that are prone to rupture or dissection has been an elusive target. Current clinical practice measures the aortic diameter and fails to relate to the pathophysiology and biomechanical properties of the aneurysm in deciding preventive surgery. Critical gap exists in the diagnosis of aneurysm especially with small aneurysms (3 - 5 cm in diameter) that are rupture prone. Based on autopsy about 10 percent of individuals with small abdominal aneurysms had undergone fatal rupture, while 40 percent with diameters of 7-10 cm had intact aneurysm and died from other causes. International Registry of Aortic Dissection found that 40% of thoracic aneurysms dissected at diameters smaller than 5 cm.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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Goal 2: Reduce Human Disease

Mechanics of aortic dissection

The mechanical events in the wall leading to aortic dissection are not well described because merely stating that cellular or biopolymer connections have weakened does not predict the path of the rupture through the media or the risk of rupture. Elucidate the mechanical role of substructures such as collagen fibers, elastin sheets, smooth muscle cells and interstitial fluid in the progression of dissection. Study in animal... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

While in recent years the lives of patients with aortic dissection have increasingly been saved, an understanding of the mechanisms involved might suggest new techniques to increase the percentage who survive aortic dissection.

Feasibility and challenges of addressing this CQ or CC

Knowing the mechanisms involved in dissection is more important than attempting to determine and measure some critical rupture stress because of the large differences between specimen aortas within a given species.

Name of idea submitter and other team members who worked on this idea Henry W. Haslach, Jr.

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Goal 3: Advance Translational Research

How can we determine a patient’s risk of a life-threatening aortic dissection?

Even though science and technology has advanced, many of the advancements have not met the critical challenge of making significant changes in patient therapies for improved outcomes and thus have not been able to break through the translational barrier. In today’s world, risk of aortic dissection is still based purely on a crude size measurement. It is true that evidence indicates that aortic root aneurysm above 4.5... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

We need tools to assess vascular function and morphology to determine the weakness and/or strength of the aorta. We need biomarkers and predicators of outcomes for aneurysms and acute aortic dissection. We also need to understand the actual physical limitation of the aorta and where there may actual be physical barriers which cannot be overcome by drug therapies.

Utilizing singe gene disorders like Marfan syndrome can help to develop the tools needed to access not only risk but can provide candidate pathways that can contribute to more complex, common and polygenetic disorders and moving research to the preclinical and clinical stage to prioritize therapeutic targets in many related and common diseases..

Name of idea submitter and other team members who worked on this idea JGrima

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