# The state of energy in the right ventricle of patients with pulmonary arterial hypertension

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2024 · $611,765

## Abstract

PROJECT SUMMARY/ABSTRACT
Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disease with a high mortality rate. In
most cases, PAH-induced chronic pressure overload leads to right ventricle (RV) failure. Right heart
catheterization (RHC) is currently the gold standard test for PAH diagnosis and follow-up. Furthermore, repeated
RHC should be considered in patients who experience unexplained clinical deterioration during their clinical
course or for periodic follow-up over time. Yet many centers across the world do not routinely perform RHC
during follow-up, for a variety of potential reasons, including its invasive nature, cost, or availability.
We have recently developed 3D echocardiographic particle image velocimetry (Echo-PIV), which allows high-
temporal volumetric assessment of RV hemodynamics. In combination with standard 3D speckle tracking, 3D
Echo-PIV enables a comprehensive assessment of hemodynamics and energy state (ventricular kinetic
energy/work and viscous energy dissipation) in the RV. The RV energy state reflects the structural and functional
changes in the RV that may occur due to PAH. Thus, it can be used as a load-independent measure to assess
RV function and monitor disease progression/regression in PAH patients.
The project's global hypothesis is that in PAH patients' follow-up, changes in the RV energy state: (1) reflect
changes in RHC-derived pulmonary arterial pressures, and (2) are associated with changes in patients' clinical
status such that it can be used to monitor disease progression and regression.
Given that in more advanced disease, RV dysfunction is present, we will gather a prospective, ethnically diverse
cohort of 210 subjects at Cedars-Sinai Medical Center: 70 PAH patients with normal RV function, 70 PAH
patients with RV dysfunction, and 70 healthy control subjects. The following Specific Aims will be accomplished:
SPECIFIC AIM 1: Investigate the accuracy of 3D Echo-PIV in characterizing 4D flow hemodynamics in the RV
using 4D Flow CMR as a reference standard and assess test/retest reproducibility of 3D Echo-PIV in PAH.
SPECIFIC AIM 2: Determine the relationship between the noninvasively derived RV energy state and RHC-
derived parameters in following up PAH patients and test whether changes in the RV energy state reflect
changes in the RHC-derived pulmonary arterial pressures in PAH patients with and without RV dysfunction.
SPECIFIC AIM 3: Investigate the feasibility of noninvasive imaging-derived RV energy state for monitoring
disease progression/regression in PAH patients.
The success of the proposed studies will establish 3D Echo-PIV as a tool for assessment of PAH patients and
will: (1) determine the relationship between noninvasive RV imaging and invasive RHC-based hemodynamics,
(2) establish whether changes in noninvasive RV energy state reflect changes in the RHC-derived parameters
in PAH patients, and (3) facilitate monitoring of disease progression/regression by noninvasive RV ene...

## Key facts

- **NIH application ID:** 10761765
- **Project number:** 5R01HL153724-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** Arash Kheradvar
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $611,765
- **Award type:** 5
- **Project period:** 2022-01-15 → 2026-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10761765

## Citation

> US National Institutes of Health, RePORTER application 10761765, The state of energy in the right ventricle of patients with pulmonary arterial hypertension (5R01HL153724-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10761765. Licensed CC0.

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