# The Cardiac Atlas Project

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $622,573

## Abstract

ABSTRACT
Cardiac malformations are the most common type of birth defect. Improvements in the management of
complex congenital heart disease have resulted in >90% of those born with congenital heart disease now able
to survive into early adulthood. In the U.S. alone, there are more adults with congenital heart disease (~1
million individuals) than children. Tetralogy of Fallot (TOF) is the commonest cyanotic congenital heart lesion,
and there is now a large and growing population of adults with TOF. The surgical repairs these patients require
early in life often lead to residual pulmonary regurgitation that can cause eventual right ventricular enlargement
and dysfunction, and pre-dispose to heart failure, arrhythmias, and sudden death. In the course of clinical
management, deciding whether and when to perform pulmonary valve replacement to prevent ventricular
decompensation is therefore critical and warrants quantifiable means of assessment.
 The goal of this project is to expand the current Congenital Heart Disease study of the Cardiac Atlas
Project database to include a large cohort of patient with post-operative TOF, and to use the patient cardiac
magnetic resonance (CMR) exams and other clinical data to derive statistical atlases of shape, biomechanics
and electrical dyssynchrony. These atlases will be used to test hypotheses and discover clinical biomarkers
that predict outcomes of pulmonary valve replacement based on variations in ventricular shape, mechanical
properties and electromechanical dyssynchrony.
 The specific aims are: (1) To use disease-specific statistical shape atlases derived from non-invasive
imaging exams of patients with TOF to test the hypothesis that specific biventricular shape modes can
discriminate patients by their degree of recovery of ventricular function and their extent of reverse cardiac
remodeling after valve replacement; (2) To use finite element models of biventricular biomechanics to
investigate the extent to which clinically significant relationships between ventricular shape modes and
improvements in ventricular function post-valve repair are due to shape alone vs. differences in myocardial
material properties; and (3) To determine how dyssynchronous electrical activation patterns that give rise to
heterogeneous regional contraction affect hemodynamic improvement and reverse ventricular remodeling after
pulmonary valve replacement in TOF patients.
 This work will have a significant impact on the clinical management of congenital heart disease by
providing: new insights into biomechanical alterations in post-operative TOF; new predictors of outcomes
following pulmonary valve replacement; and a greatly expanded web-accessible database of CMR exams,
models and statistical atlases to facilitate clinical research and training in congenital heart disease.

## Key facts

- **NIH application ID:** 9990835
- **Project number:** 5R01HL121754-06
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Andrew D. McCulloch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $622,573
- **Award type:** 5
- **Project period:** 2014-01-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990835

## Citation

> US National Institutes of Health, RePORTER application 9990835, The Cardiac Atlas Project (5R01HL121754-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9990835. Licensed CC0.

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