CMRai project: Detecting the vulnerable aorta in MRI for precision cardiovascular medicine

The aortic aneurysm is a permanent dilation of the aorta whose consequences, in the event of rupture, can be fatal. If diagnosed early enough, treatment often relies on managing high blood pressure. In other cases, surgery is considered to treat the aneurysm as soon as possible. But unfortunately the diagnosis is often late, made during the rupture, and constitutes a dramatic event associated with a mortality rate of 80-90%. It is in this context that it is necessary to better detect aortic aneurysms in the French population. So how can we better prevent aortic ruptures? This is the challenge taken up by the CMRAI project led by the IHU-ICAN and Sorbonne University and funded by EIT Health.

This project, set up at the initiative of the IHU-ICAN and coordinated by its founder Sorbonne University, brings together 9 European partners: Assistance Publique-Hôpitaux de Paris (France), the Hanover School of Medicine (Germany), the Medical University of Vienna (Austria), Vall d’Hebron Hospital (Spain), Santa Cruz Hospital (Portugal), Lisbon University of Sciences (Portugal), including 2 industrial partners: Imageens (France ) and Siemens Healthineers (Germany).

The objective of the CMRAI project is to create a platform that will make it possible to define, from the first signs of the disease, an aortic aneurysm risk score for each patient, and therefore to define a personalized follow-up and management strategy.

This project proposes to go beyond the practice based on diameter alone by proposing an evaluation of new functional parameters in MRI accounting for the elasticity of the wall of the aortic aneurysm, the shear forces applied to its wall, the pressure regime and the disturbances of the resulting blood flows.

These innovative parameters from algorithms developed by the LIB biomedical imaging laboratory (Inserm/SU/CNRS) will be studied in two populations: in patients with a thoracic aortic aneurysm as part of a clinical study in 5 European reference centers and in healthy subjects recruited from the Constances cohort (Inserm) in France in order to establish the normal values expected in the general population.

Led by Prof. Alban Redheuil, head of Cardiovascular and Thoracic Imaging (ICT) at Pitié-Salpêtrière hospital and medical manager of the ICAN Imaging platform, by Dr Nadjia Kachenoura, head of the cardiovascular imaging team ( iCV) of the Biomedical Imaging Laboratory (LIB) and by Ted Baldwin CEO of the start-up Imageens, the CMR projectAI involves several departments of the IHU-ICAN:

Expected results

CMRAI will therefore allow the screening of the aortic aneurysm, the therapeutic decision-making and the adapted and personalized care thanks to Magnetic Resonance Imaging (MRI) coupled with the automated and multiparametric analysis of the aorta.

This study contributes to the development of precision medicine in cardiometabolic diseases. This is a major project that has obtained EIT Health funding.