Multiscale Imaging of Cardiovascular Pressure Gradients – a Paradigm Shift in Hemodynamic Risk Prediction

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Regional quantification of cardiovascular pressure gradients is critical for diagnosis, treatment planning, and risk prediction of many cardiovascular diseases. Still, for a large number of conditions, non-invasive assessment is obstructed by inherent method limitations, and a wide range of cardiovascular instances exist where regional pressure behaviour remains unexplored. The MultiPRESS project main objective is to develop a novel imaging paradigm for non-invasive assessment of cardiovascular pressure gradients, overcoming critical limitations of existing techniques through a unique multiscale approach. Doing so, the MultiPRESS project seeks to – for the first time – extend non-invasive hemodynamic risk prediction into previously inaccessible cardiovascular domains, advance our knowledge of complex hemodynamic behaviour, and tackle remaining urgent clinical challenges across the heart, aorta, and brain. Using deep integration of advanced full-field magnetic resonance imaging (4D Flow MRI), super-resolution networks, and physics-informed image processing, a set of core developments will allow for unique, comprehensive image-based pressure gradient assessment across (1) spatial (big/small vessels), (2) temporal (fast/slow flows), and (3) flow (laminar/turbulent) scales, with developments consistently validated in dedicated in-silico, in-vitro, and in-vivo cohorts. These developments will then be utilized on a set of core applications across (4) cardiovascular scales (heart/aorta/brain), addressing urgent clinical challenges and extending image-based pressure gradient quantification through previously inaccessible domains. Based in a unique multidisciplinary setting at Scandinavia’s largest university hospital, successful delivery of MultiPRESS will represent a paradigm shift in clinical hemodynamic risk prediction, and pave way for new scientific knowledge revitalizing risk stratification of complex cardiovascular disease across the heart, aorta, and brain.