In a collaboration between VCU’s College of Engineering and School of Medicine, researchers are testing novel imaging methods to assess a patient’s risk of life-threatening dissection of the aorta.
John Wilson, M.D., Ph.D., an assistant professor in the Department of Biomedical Engineering and at VCU Pauley Heart Center, and Uyen Truong, M.D., an associate professor in the Department of Pediatrics, Division of Cardiology, have teamed up to see how novel imaging techniques may give physicians more information to identify an individual patient’s risk for an aortic dissection, a condition in which a tear can weaken and possibly rupture the aorta (the large artery that moves blood from the heart to the body).
Wilson researches non-invasive MRI approaches to quantify aortic wall strain, which is “a measure of deformation of how the aorta changes in shape as the blood goes through it. We use that information to give us new data that might help clinicians make decisions on how to best diagnose and potentially treat aortic diseases like aneurysms and dissections,” he said.
In their joint study of patients from early childhood through adulthood, which is supported by a VCU Presidential Research Quest Fund (PeRQ) grant, they are focusing on patients with Marfan syndrome or hypertension (high blood pressure). Marfan syndrome is an inherited disorder in which connective tissue, such as that in the aortic wall, can be weakened. Hypertension is also a risk factor for aortic dissections.
Truong said, “One of the biggest concerns with Marfan patients is aortic rupture or tears in the wall. We’re trying to determine factors that can identify — early on — patients with increased risk of dissections and tears in the aortic wall.”
Wilson is applying an MRI technique that was developed for imaging in the heart to the aorta. By running a scan and considering the function of the aorta even if the structure appears normal, he said, clinicians could be made aware of “subtle signs that you can’t see without using these special techniques. By giving them more specific data for a person based on the imaging studies and the mechanical analysis we do, perhaps we can give new information that could predict dissections before they occur.”
That kind of data can help guide clinical decisions, Truong said. “In patients in whom we see abnormal early changes, should you start implementing medications, for example, sooner rather than later, or different classes of medications to mediate aortic dilation?”
For pediatric patients, she said, “There’s so much room to improve the lives of these children. The approach that we’re doing is non-invasive, so it doesn’t expose the children to any kind of radiation or danger. But it provides an incredible amount of information.”