First Name
Ramkumar
Last Name
Krishnamurthy
Degree
Ph.D.
Address
6701 Fannin st Suite D1280.12
Houston, Texas 77030
United States
Phone Number
(832) 822-5591
Email
rxkrish1@texaschildrens.org
Upload Cover Letter
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Investigator/Applicant Cory
First Name
Investigator/Applicant V
Name MI
Investigator/Applicant Noel
Last Name
Investigator/Applicant MD
Degree
Investigator/Applicant
Name Address
6621 Fannin St, Cardiology, 19th floor West Tower
Houston, Texas 77030
United States
Investigator/Applicant cvnoel@texaschildrens.org
Name Email
Title
Understanding Cardiac Biomechanics in Congenital Heart Disease: A Serial Imaging
Study of Single Ventricle Pediatric Patients using Cardiac MRI
Abstract of Proposed Research Plan (300 words)
Background and Significance:
Knowledge about single ventricular function and mechanics has lagged behind that of the left or right
ventricle in a bi-ventricular heart. There is evidence of a worse prognosis in patients with a single RV (SRV)
when compared to patients with a single LV (SLV), likely related to an intrinsic difference in systolic
mechanics between systemic RV and systemic LV. Similarly, for patients with dual ventricles (DV) down a
single systemic ventricular pathway, there is paucity of biomechanics data. A better understanding of the
biomechanics might lead to a change in medical management of patients.
Hypothesis:
a) By performing serial imaging on asymptomatic patients status post TCPC, unique information on the
evolution of myocardial function can be obtained,
b) Using high temporal resolution MR imaging in a study that captures the complete cardiac cycle (systole
and diastole), we can develop imaging biomarkers that significantly highlight the differences in cardiac
biomechanics and ventricular dysfunction between SLV, SRV and DV patients.
Methods:
We plan to image 60 patients (20 systemic single LV, 20 systemic single RV, 10 normal and 10 DV). At
least 6 patients in each patient group would be recruited from a population previously imaged using
similar methodology to yield serial data of biomechanics evolution.
Biomarkers characterizing myocardial biomechanics, namely - peak strain, time to peak strain, strain rate,
torsion, systolic and diastolic function would be calculated in each group and compared. For the serial
imaging, peak strain and torsion at end-systole will be compared with prior data.
Expected Outcome:
This study would:
1) Bridge the knowledge gap that exists between outcome series studies and imaging studies, and would
add more confidence to the scientific community about the suspected differences between SLV, SRV and
DV patients.
2) Establish appropriate MR imaging biomarkers to follow up on patients with single ventricles.
Upload: Detailed plan
and bibliography
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Resources and Environment:
Resources and Environment/Major Equipment:
All research will be conducted in the main campus of the Texas Children’s Hospital (TCH). The offices of
the PI, mentor and co-PI are situated in the main campus and are within a few minutes walking distance.
The department of pediatric Radiology at TCH has 7 MRI scanners (5 - 1.5T, 2 - 3T, all from Philips
Healthcare) in its main campus. 5 of them are used for cardiac imaging. These scanners are equipped with
equipped with state of the art hardware (32/ 28 channel cardiac coil, multi-transmit systems) for faster
imaging. TCH also has an Advanced Image Processing Lab that contains the needed computing power as
well as software licenses for post processing. There would be a licensing fee involved in extending the
license of the computational software (DiagnosoftTM) beyond 2015.
TCH has partnered with Baylor College of Medicine for obtaining the institutional review board’s approval
prior to conducting the study. The PI does not see any significant hurdle/delay in obtaining this approval,
as a similar approval had been obtained before. The research co-ordinator in the department of Radiology
(Ms. Shireen Hayatghaibi) has significant experience in the IRB process, and also in patient recruitment and
consenting process. Also, our department statistician (Dr. Wei Zhang) would be a significant help for all
our statistics needs. The PI has easy access to both.
Recruiting 50 patients with single ventricles over the period of a year might be a bottle neck. However, we
are planning to recruit only around 25 new patients. As the other half would be patients already studied,
we anticipate an easier patient recruitment within the proposed time line.
The PI (Dr. Ramkumar Krishnamurthy) has easy access to all these resources (equipment, software and
personnel). He is involved in the day to day activities in all aspects of cardiac clinical research at TCH. The
PI has excellent working relationship with Philips healthcare clinical scientists, and Texas Children’s
Hospital has an active research exhibit signed with Philips health care. The PI has extensive experience in
using the necessary post-processing software.
The mentor of this project (Dr. Rajesh Krishnamurthy) is the Director of Research at the Pediatric Radiology
department at Texas Children’s Hospital, and also serves as the Director of clinical Cardiovascular
Imaging. He supervised the initial project of understanding cardiac biomechanics in single ventricle
patients. He is also an active part of the single ventricle program at Texas Children’s Hospital. He provides
valuable insights and guidance on the biomechanics of single ventricles.
The co-PI, Dr. Cory Noel is a cardiologist by training and an active part of single ventricle program at
Texas Children’s Hospital, one of the largest patient populations of single ventricle patients in the country.
He will be actively involved in the recruitment of the patients, as well as in providing clinical insights
Major Equipment:
Included in resources and environment
Additional Information:
Investigators:
PI: Ramkumar Krishnamurthy, Ph.D. is a senior research scientist/ Imaging scientist at Texas Children’s
Hospital’s department of Radiology. He has extensive experience in cardiac magnetic resonance imaging,
and high-temporal resolution cardiac MRI.
He will spend 20% of his time on the project. His responsibilities include:
1. Oversight of the entire project
2. Oversight of planning and performance of the cardiac MR research study.
3. Perform all post-processing/data analysis required for fulfilling the specific aims
4. Assist with image interpretation and analysis for Specific Aims, and statistical analysis.
5. Oversight of publications resulting from study.
Co-PI : Cory Noel, MD is a cardiologist by training and an active part of single ventricle program at Texas
Children’s Hospital, one of the largest patient populations of single ventricle patients in the country.
He will spend 5% of his time on the project. His responsibilities include:
1. Oversight of subject recruitment and consent. He will coordinate with the cardiologists who refer single
ventricle patients to a clinically indicated cardiac MRI.
2. Supervise collection of follow-up data on patients
3. Assist with statistical analysis of imaging data.
4. Coordinate with cardiologists to appropriately manage incidental findings.
Mentor: Rajesh Krishnamurthy, MD is the Director of imaging research and the Director of cardiovascular
imaging at Texas Children’s Hospital. He supervised the initial project of understanding cardiac
biomechanics in single ventricle patients. He is also an active part of the single ventricle program at Texas
Children’s Hospital.
Duration of study: 12 months for data collection/data processing from time of study commencement, 3
months for analysis of results, draft preparation (last 2 months of the 12 month data collection).
Deliverables: The PI plans to submit the results of this study as an abstract to the annual conference of
Society of Pediatric Radiology, and have a manuscript submitted to the journal of the same society.
Award Payee First
Ramkumar
Name
Award Payee Last
Krishnamurthy
Name
Award Payee
PhD
Degree
Award Payee Address
6701 Fannin st Suite D.1280.12
Houston, Texas 77030
United States
Award Payee Phone
(832) 822-5591
Number
Award Payee Email
rxkrish1@texaschildrens.org
Grant Administrator's
Matthew
First Name
Grant Administrator's
Cabral
Last Name
Grant Administrator's
Ph.D.
Degree
Grant Administrator's
Address
One Baylor Plaza, Suite 600D, MS BCM310 Sponsored Programs Office, Baylor
College of Medicine
Houston, Texas 77030
United States
Grant Administrator's
(713) 798-6908
Phone Number
Grant Administrator's
mcabral@bcm.edu
Email
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Vitae
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