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Heart & Vascular Institute

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Lima Lab

The Lima lab’s research is concentrated on the development and application of imaging and technology to address scientific and clinical problems involving the heart and vascular system. Our research is focused on developing MR contrast techniques to investigate microvascular function in patients and experimental animals with myocardial infarction; functional reserve secondary to dobutamine stimulation and myocardial viability assessed by sodium imaging. Cardiac MR and CT program development of techniques to characterize atherosclerosis in humans with cardiovascular or cerebrovascular disease.

Funding

Our current funding is from NIH: NHLBI.

Members

Faculty:

PI: Joao Lima, MD
Co-PI: Sam Gidding, MD
Co-investigator: David Bluemke, MD, PhD

Staff:

Erin Ricketts, Study Manager
Ellen Stengel, Lead technician
Ela Chamera, Sonographer/Analyst
Chia-Ying Liu

Fellows:

Harjit Chahal
Aditya Jain
Cuilian Miao
Jan Skrok
Monda Shehata
Evrim Turkbey
Andre Almeida
Anders Opdahl
Eui-Young Choi

Projects

1) The Coronary Artery Risk Development in Young Adults (CARDIA) Study

This is a longitudinal study of the antecedents and risk factors for cardiovascular disease in a cohort of 5,115 black and white men and women aged 18-30 years at their initial examination in 1985-1986. In year 25 (2010-2011), these participants will be given an echocardiography examination. Johns Hopkins has been awarded the contract to read these echos.

2) The MESA (Multi-Ethnic Study of Atherosclerosis) Study

This is an important medical research study that involves more than 6,000 men and women from six communities in the United States. Participants in MESA come from diverse racial and ethnic groups, including African Americans, Latinos, Asians, and Caucasians. Participants have gotten a cardiac MRI in previous years and will get a follow-up one in exam 5 (2010 and 2011). Johns Hopkins has been awarded the contract to read these MRIs.

3) The Core 64 Trial:

The Coronary Artery Evaluation using 64-row Multidetector Computed Tomography Angiography (CORE64) study was a prospective, multicenter diagnostic study which utilized centralized blinded analysis to determine the diagnostic accuracy of 64-detector 0.5mm slice thickness MDCT angiography in comparison with conventional coronary angiography (CCA), in patients with suspected CAD. The study was designed to determine whether 64-detector MDCT angiography can reliably define the presence or absence of obstructive disease and also identify those patients who may require coronary revascularization. Nine centers enrolled 291 patients who completed MDCT angiography prior to CCA, and had calcium scores ?600. Diameter stenoses ?50% were considered obstructive. The Core-64 trial showed that 64-detector MDCT angiography has reliable accuracy for the diagnosis of obstructive coronary disease. The area under the receiver operating characteristic curve of 0.93 is consistent with robust diagnostic performance and indicates that 64-detector MDCT angiography has powerful discriminative ability to identify patients with and without coronary obstruction. Additionally, MDCT angiography compared well with CCA in predicting clinically-driven revascularization and severity of obstructive CAD which supports its clinical utility for identifying symptomatic patients who may need coronary interventions.

Publications

  1. Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, Greenland P, Jacob DR, Jr., Kronmal R, Liu K, Nelson JC, O'Leary D, Saad MF, Shea S, Szklo M, Tracy RP. Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol. 2002;156(9):871-881.

  2. Li AE, Kamel I, Rando F, Anderson M, Kumbasar B, Lima JA, Bluemke DA. Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age. AJR Am J Roentgenol. 2004;182(3):593-597.

  3. Castillo E, Osman NF, Rosen BD, El-Shehaby I, Pan L, Jerosch-Herold M, Lai S, Bluemke DA, Lima JA. Quantitative assessment of regional myocardial function with MR-tagging in a multi-center study: interobserver and intraobserver agreement of fast strain analysis with Harmonic Phase (HARP) MRI. J Cardiovasc Magn Reson. 2005;7(5):783-791.

  4. Rosen BD, Edvardsen T, Lai S, Castillo E, Pan L, Jerosch-Herold M, Sinha S, Kronmal R, Arnett D, Crouse JR, III, Heckbert SR, Bluemke DA, Lima JA. Left ventricular concentric remodeling is associated with decreased global and regional systolic function: the Multi-Ethnic Study of Atherosclerosis. Circulation. 2005;112(7):984-991.

  5. Edvardsen T, Detrano R, Rosen BD, Carr JJ, Liu K, Lai S, Shea S, Pan L, Bluemke DA, Lima JA. Coronary artery atherosclerosis is related to reduced regional left ventricular function in individuals without history of clinical cardiovascular disease: the Multiethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2006;26(1):206-211.

  6. Edvardsen T, Rosen BD, Pan L, Jerosch-Herold M, Lai S, Hundley WG, Sinha S, Kronmal RA, Bluemke DA, Lima JA. Regional diastolic dysfunction in individuals with left ventricular hypertrophy measured by tagged magnetic resonance imaging–The Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J. 2006;151(1):109-114.

  7. Rosen BD, Saad MF, Shea S, Nasir K, Edvardsen T, Burke G, Jerosch-Herold M, Arnett DK, Lai S, Bluemke DA, Lima JA. Hypertension and Smoking Are Associated With Reduced Regional Left Ventricular Function in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis. Journal of the American College of Cardiology. 2006;47(6):1150-1158.

  8. Natori S, Lai S, Finn P, Gomes AS, Hundley WG, Jerosch-Herold M, Pearson G, Sinha S, Arai A, Lima JA, Bluemke DA. Cardiovascular function in multi-ethnic study of atherosclerosis: normal values by age, sex, and ethnicity. Am J Roentgenol. 2006;186(6 Suppl 2):S357-365.

  9. Fernandes VR, Polak JF, Edvardsen T, Carvalho B, Gnomes A, Bluemke DA, Nasir K, O’Leary DH, Lima JA. Subclinical Atherosclerosis and Incipient Regional Myocardial Dysfunction in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis (MESA). J Am Coll Cardiol. 2006;47(12):2420-2428.

  10. Rosen BD, Lima JA, Nasir K, Edvardsen T, Folsom AR, Lai S, Bluemke DA, Jerosch-Herold M. Lower Myocardial Perfusion Reserve Is Associated With Decreased Regional Left Ventricular Function in Asymptomatic Participants of the Multi-Ethnic Study of Atherosclerosis. Circulation. 2006;114(4):289-297.

  11. Adame IM, van der Geest RJ, Bluemke DA, Lima JA, Reiber JH, Lelieveldt BP. Automatic Vessel Wall Contour Detection and Quantification of Wall Thickness in In-Vivo MR Images of the Human Aorta. J Magn Imaging. 2006;24(3):595-602.

  12. Heckbert SR, Post W, Pearson GD, Arnett DK, Gomes AS, Jerosch-Herold M, Hundley WG, Lima JA, Bluemke DA. Traditional Cardiovascular Risk Factors in Relation to Left Ventricular Mass, Volume, and Systolic Function by Cardiac Magnetic Resonance Imaging: The Multiethnic Study of Atherosclerosis. J Am Coll Cardiol. 2006;48(11):2285-2292.

  13. Tandri H, Daya SK, Nasir K, Bomma C, Lima JA, Calkins H, Bluemke DA. Normal Reference Values for the Adult Right Ventricle by Magnetic Resonance Imaging. Am J Cardiol. 2006;98(12):1660-1664.

  14. Nasir K, Tsai M, Rosen BD, Fernandes V, Bluemke DA, Folsom AR, Lima JA. Elevated Homocysteine Is Associated With Reduced Regional Left Ventricular Function. The Multi-Ethnic Study of Atherosclerosis. Circulation. 2007;115(2):180-187.

  15. Rosen BD, Cushman M, Nasir K, Bluemke DA, Edvardsen T, Fernandes V, Lai S, Tracy RP, Lima JA. Relationship between C-reactive protein levels and regional left ventricular function in asymptomatic individuals: the Multi-Ethnic Study of Atherosclerosis. J Am Coll Cardiol. 2007;49(5):594-600.

  16. Nasir K, Rosen BD, Kramer HJ, Edvardsen T, Bluemke DA, Liu K, Lima JA. Regional left ventricular function in individuals with mild to moderate renal insufficiency: the Multi-Ethnic Study of Atherosclerosis. Am Heart J. 2007;153(4):545-551.

  17. Cheung N, Bluemke DA, Klein R, Sharrett AR, Islam FM, Cotch MF, Klein BE, Criqui MH, Wong TY. Retinal arteriolar narrowing and left ventricular remodeling: the multi-ethnic study of atherosclerosis. J Am Coll Cardiol. 2007;50(1):48-55.

  18. Fernandes VR, Edvardsen T, Rosen BD, Carvalho B, Campos O, Cordeiro MA, Kronmal R, Bluemke DA, Lima JA. The influence of left ventricular size and global function on regional myocardial contraction and relaxation in an adult population free of cardiovascular disease: a tagged CMR study of the MESA cohort. J Cardiovasc Magn Reson. 2007;9(6):921-930.

  19. Fernandes VR, Polak JF, Cheng S, Rosen BD, Carvalho B, Nasir K, McClelland R, Hundley G, Pearson G, O’Leary DH, Bluemke DA, Lima JA. Arterial Stiffness Is Associated With Regional Ventricular Systolic and Diastolic Dysfunction. The Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2008;28(1):194-201.

  20. Wasserman BA, Sharrett AR, Lai S, Gomes AS, Cushman M, Folsom AR, Bild DE, Kronmal RA, Sinha S, Bluemke DA. Risk Factor Associations with the Presence of a Lipid Core in Carotid Plaque of Asymptomatic Individuals Using High-Resolution MRI. The Multi-Ethnic Study of Atherosclerosis (MESA). Stroke. 2008;39(2):329-335.

  21. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA. Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups. N Engl J Med. 2008;358(13):1336-1345.

  22. Brown ER, Kronmal RA, Bluemke DA, Guerci AD, Carr JJ, Goldin J, Detrano R. Coronary Calcium Coverage Score: Determination, Correlates and Predictive Accuracy in the Multi-Ethnic Study of Atherosclerosis. Radiology. 2008;247(3):669-675.

  23. Nasir K, Katz R, Mao S, Takasu J, Bomma C, Lima JA, Bluemke DA, Kronmal R, Carr JJ, Budoff MJ. Comparison of left ventricular size by computed tomography with magnetic resonance imaging measures of left ventricle mass and volumes: The multi-ethnic study of atherosclerosis. J Cardiovasc Comput Tomogr. 2008;2(3):141-148.

  24. Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA, Budoff MJ, Liu K, Shea S, Szklo M, Tracy RP, Watson KE, Burke GL. Coronary Artery Calcification Compared With Carotid Intima-Media Thickness in Prediction of Cardiovascular Disease Incidence: The Multi-Ethnic Study of Atherosclerosis (MESA). Arch Intern Med. 2008;168(12):1333-1339.

  25. Malayeri AA, Johnson WC, Macedo R, Bathon J, Lima JA, Bluemke DA. Cardiac Cine MRI: Quantification of the Relationship Between Fast Gradient Echo and Steady-State Free Precession for Determination of Myocardial Mass and Volumes. J Magn Reson Imaging. 2008;28(1):60-66.

  26. Malayeri AA, Natori S, Bahrami H, Bertoni AG, Kronmal R, Lima JA, Bluemke DA. Relation of Aortic Wall Thickness and Distensibility to Cardiovascular Risk Factors (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol. 2008;102(4):491-496.

  27. Bahrami H, Kronmal R, Bluemke DA, Olson J, Shea S, Liu K, Burke GL, Lima JA. Differences in The Incidence of Congestive Heart Failure by Ethnicity: The Multi-Ethnic Study of Atherosclerosis. Arch Intern Med. 2008;168(19):2138-2145.

  28. Moran A, Katz R, Jenny NS, Astor B, Bluemke DA, Lima JA, Siscovick D, Bertoni AG, Shlipak MG. Left Ventricular Hypertrophy in Mild and Moderate Reduction in Kidney Function Determined Using Cardiac Magnetic Resonance Imaging and Cystatin C: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Kidney Dis. 2008;52(5):839-848.

  29. Macedo R, Chen S, Lai S, Shea S, Malayeri AA, Szklo M, Lima JA, Bluemke DA. MRI Detects Increased Coronary Wall Thickness in Asymptomatic Individuals: The Multi-Ethnic Study of Atherosclerosis (MESA). J Magn Reson Imaging. 2008;28(5):1108-1115.

  30. Daniel KR, Bertoni AG, Ding J, Johnston S, Budoff MJ, Bluemke DA, Carr JJ. Comparison of methods to measure heart size using noncontrast-enhanced computed tomography: correlation with left ventricular mass. J Comput Assist Tomogr. 2008 ;32(6):934-941.

  31. Bluemke DA, Kronmal RA, Lima JA, Liu K, Olson J, Burke GL, Folsom AR. The relationship of left ventricular mass and geometry to incident cardiovascular events: the MESA (Multi-Ethnic Study of Atherosclerosis) study. J Am Coll Cardiol. 2008;52(25):2148-2155.

  32. Malayeri AA, Macedo R, Li D, Chen S, Bahrami H, Lai S, Lima JA, Bluemke DA. Coronary vessel wall evaluation by magnetic resonance imaging in the multi-ethnic study of atherosclerosis: determinants of image quality. J Comput Assist Tomogr. 2009;33(1):1-7.

  33. Van Hee VC, Adar SD, Szpiro AA, Barr RG, Bluemke DA, Diez Roux AV, Gill EA, Sheppard L, Kaufman JD. Exposure to Traffic and Left Ventricular Mass and Function The Multi-Ethnic Study of Atherosclerosis. Am J Respir Crit Care Med. 2009;179(9):827-834.

  34. Miao C, Chen S, Macedo R, Lai S, Liu K, Li D, Wasserman BA, Vogel-Clausen J, Lima JA, Bluemke DA. Positive remodeling of the coronary arteries detected by magnetic resonance imaging in an asymptomatic population: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2009;53(18):1708-1715.

  35. Delaney JA, McClelland RL, Brown E, Bluemke DA, Vogel-Claussen J, Lai S, Heckbert SR. Multiple imputation for missing with cardiac magnetic resonance imaging data: Results from the Multi-Ethnic Study of Atherosclerosis (MESA). Can J Cardiol. 2009;25(7):e232-235.

  36. Rosen BD, Fernandes VR, Nasir K, Helle-Valle T, Jerosch-Herold M, Bluemke DA, Lima JA. Age, Increased Left Ventricular Mass, and Lower Regional Myocardial Perfusion Are Related to Greater Extent of Myocardial Dyssynchrony in Asymptomatic Individuals. The Multi-Ethnic Study of Atherosclerosis. Circulation. 2009;120(10):859-866.

  37. Duprez DA, Jacobs DR Jr, Lutsey PL, Herrington D, Prime D, Ouyang P, Barr RG, Bluemke DA. Race/ethnic and sex differences in large and small artery elasticity -- results of the multi-ethnic study of atherosclerosis (MESA). Ethn Dis. 2009;19(3):243-250.

  38. Liu L, Nettleton JA, Bertoni AG, Bluemke DA, Lima JA, Szklo M. Dietary pattern, the metabolic syndrome, and left ventricular mass and systolic function: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr. 2009 Jun 10. [Epub ahead of print]

  39. Ding J, Hsu FC, Harris TB, Liu Y, Kritchevsky SB, Szklo M, Ouyang P, Espeland MA, Lohman KK, Criqui MH, Allison M, Bluemke DA, Carr JJ. The association of pericardial fat with incident coronary heart disease: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2009 Jul 1. [Epub ahead of print]

  40. Stacey RB, Bertoni AG, Eng J, Bluemke DA, Hundley WG, Herrington D. Modification of the Effect of Glycemic Status on Aortic Distensibility by Age in the Multi-Ethnic Study of Atherosclerosis. Hypertension. (In press)

  41. Turkbey EB, Jorgensen NW, Johnson WC, Bertoni AG, Polak JF, Diez Roux AV, Ainsworth B, Tracy RP, Lima JA, Bluemke DA. Physical Activity and Heart Size and Function: the Multi-Ethnic Study of Atherosclerosis (MESA). Heart. (In press)

  42. Turkbey EB, McClelland RL, Kronmal RA, Burke GL, Bild DE, Tracy RP, Arai AE, Lima JA, Bluemke DA. Obesity in Relationship to LV size and Function: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC: Cardiovascular Imaging. (In press)

  43. Miller, J. M., Rochitte, C. E., Dewey, M., Arbab-Zadeh, A., Niinuma, H., Gottlieb, I., et al. (2008). Diagnostic performance of coronary angiography by 64-row CT. The New England Journal of Medicine, 359(22), 2324-2336.

  44. Miller, J. M., Dewey, M., Vavere, A. L., Rochitte, C. E., Niinuma, H., Arbab-Zadeh, A., et al. (2009). Coronary CT angiography using 64 detector rows: Methods and design of the multi-centre trial CORE-64. European Radiology, 19(4), 816-828.

  45. Joanna J. Wykrzykowska, Armin Arbab-Zadeh, Gustavo Godoy MD, Julie M. Miller, Shezhang Lin MD, Andrea Vavere, Narinder Paul, Hiroyuki Niinuma, John Hoe, Jeffrey Brinker,Faisal Khosa, Sheryar Sarwar, Joao Lima, Melvin E. Clouse. (2009). Assessment of In-stent Restenosis Using 64-MDCT: Analysis of the CORE-64 Multicenter International Trial. American Journal of Roentgenology, In Press May 2009.

  46. Marc Dewey, Andrea L. Vavere, Armin Arbab-Zadeh, Julie M. Miller, Leonardo Sara; Christopher Cox; Ilan Gottlieb, Kunihiro Yoshioka, Narinder Paul, John Hoe, Albert de Roos, Albert C. Lardo, Joao A. Lima, Melvin E. Clouse. (2009). Patient Characteristics as Predictors of Image Quality and Diagnostic Accuracy of MDCTA Compared to Catheter Coronary Arteriography for the Detection of Obstructive Coronary Artery Disease: Core 64 Multi-Center International Trial. American Journal of Roentgenology, In Press July 2009.

  47. Ilan Gottlieb, Julie M. Miller, Armin Arbab-Zadeh, Marc Dewey, Melvin E. Clouse, Leonardo Sara, Hiroyuki Niinuma, David E. Bush, Narinder Paul, Andrea L. Vavere, John Texter, Jeffery Brinker, João AC Lima, Carlos E Rochitte. (2009). The Absence of Coronary Calcification Does Not Exclude Obstructive Coronary Artery Disease or the Need for Revascularization in Patients Referred for Conventional Coronary Angiography. Journal of American College of Cardiology, In Press August 2009.