Making Waves in Predicting Aortic Aneurysms and Postpartum Complications
Pitt bioengineer Rama Mukkamala will study arterial waveforms as a predictive measure of aortic aneurysm size and fluid overload status in postpartum women
A ruptured abdominal aortic aneurysm is the 15th leading cause of death in the United States and has stolen the lives of everyday people and luminaries alike, such as Albert Einstein and George C. Scott. This unpredictable condition causes our body’s largest vessel to dilate, often unnoticed until it is too late. Once ruptured, the mortality rate is roughly 80 percent.
The University of Pittsburgh’s Ramakrishna Mukkamala will use his lab’s expertise in cardiovascular health technology to advance a convenient monitoring device that can predict aortic aneurysm (AA) growth and the risk of rupture, using devices as common as a smartphone camera or smart scale. The project recently received a $410,344 award from the National Institutes of Health.
“This condition is typically detected by chance,” said Mukkamala, professor of bioengineering at Pitt’s Swanson School of Engineering and professor of anesthesiology and perioperative medicine at Pitt’s School of Medicine. “Despite the risks associated with rupture, ultrasound scans are hardly used to screen for aortic aneurysms because they are too inconvenient. Our proposed device could create a bridge to ultrasound scans by providing a convenient and cost-effective way to indicate aneurysm size.”
Our proposed device could create a bridge to ultrasound scans by providing a convenient and cost-effective way to indicate aneurysm size.
In this project, Mukkamala’s team will study arterial waveforms to determine if they can be used as a non-imaging solution for AA screening. These measurements are easy to obtain because they can be recorded by placing a smartphone’s camera on the neck or stepping onto a smart scale.
“We have already established that there is a connection between waveform measurements and aneurysm size,” Mukkamala said. “We will use a collection of patient data to develop methods that can predict aneurysm size from these waveforms as accurately as possible.”
If successful, the lab will develop a point-of-care device for AA screening and surveillance. This simple tool could be better than a physical exam and used in a routine doctor appointment to indicate if a more accurate ultrasound should be ordered.
“Ultimately, this simple step could be of value to patients unaware of a ticking time bomb in their chest,” Mukkamala added. “As the general population ages, this type of work becomes increasingly more relevant.”
Ultimately, this simple step could be of value to patients unaware of a ticking time bomb in their chest.
Predicting Complications Postpartum
Another relevant cardiac health trend is the United States’ growing maternal mortality rate -- the worst among industrialized countries. The majority of maternal deaths occur postpartum and result from hypertensive disorders like preeclampsia and gestational hypertension.
“A subset of women with high blood pressure in pregnancy develop fluid overload and heart failure symptoms postpartum, which can lead to an increased risk of hospital readmission and significant complications after delivery,” explained Alisse Hauspurg, assistant professor of obstetrics, gynecology, and reproductive sciences at Pitt’s School of Medicine.
Mukkamala is a co-investigator on an NIH Trailblazer award led by Hauspurg that also uses arterial waveforms to predict fluid buildup in patients with preeclampsia. Pitt’s Sanjeev Shroff, distinguished professor and Gerald E. McGinnis Chair of bioengineering; and Aman Mahajan, Peter and Eva Safar Professor and chair of anesthesiology and perioperative medicine and professor of bioengineering, will also collaborate on the project.
“Home blood pressure monitors improve manageability of hypertension,” Mukkamala said, “but they do not reduce the incidence of postpartum hospital readmission related to fluid overload.”
Mukkamala and Hauspurg will develop a smartphone-based device for convenient monitoring of postpartum fluid overload. Such a device could indicate which patients should receive more aggressive treatment prior to discharge and may potentially save the life of a new mother.
The aortic aneurysm R21 also includes Jin-Oh Hahn (Co-I), associate professor of mechanical engineering at the University of Maryland; Hao-min Cheng, professor at the National Yang Ming Chiao Tung University; and Rabih Chaer, professor of surgery at Pitt. Hyagriv Simhan, professor of obstetrics, gynecology, and reproductive sciences at Pitt, will collaborate on the Trailblazer award.