Prognostic significance of T wave variability

描述(由申请人提供)： 此应用程序的总体目标是支持主体 研究人员的职业发展侧重于以患者为中心的研究。 为了实现这一目标，拟议的方案既有培训，也有 科学的组成部分。培训部分将由教学部分组成 课程作业和书面论文的准备，最终获得硕士学位 临床研究理科学位。这一创新的学位课程是 由流行病和预防医学系在 马里兰大学。课程将提供临床方面的培训。 研究方法包括生物统计学，负责任的研究行为， 临床流行病学，以及研究研究的设计和实施。这个 该提案的科学部分侧重于初级预防 心源性猝死。心脏性猝死仍然是一个常见的临床问题 在美国，每年有超过35万人死亡。左撇子患者 心脏收缩功能不全的风险特别高。 导致心源性猝死的室性心律失常。的目标是 这项研究是为了开发一种新的方法来识别那些 最有可能罹患恶性室壁的收缩功能障碍 心律不齐。如果可以确定高危亚群，这些患者是 可能受益于通过植入性血管进行预防性治疗 心律转复除颤器(ICD)这项建议的重点是发展 两种新的风险分层技术独立量化 心室复极的动态变化：T波变异性和T波 另类人。科学计划将检验以下假设：1)T 波变率和T波交替均为心律失常事件的预测指标 在缺血性心肌病患者中。2)T升高的患者 预防ICD可使波形变异性获得更大的死亡率收益 植入。

DESCRIPTION (provided by applicant): The overall objective of this application is to support the principal investigator's development in a career focused on patient-oriented research. To accomplish this objective, the proposed program has both training and scientific components. The training component will consist of didactic coursework and preparation of a written thesis, culminating in a Master of Science degree in Clinical Investigation. This innovative degree program is offered by the Department of Epidemiology and Preventive Medicine at the University of Maryland. The coursework will provide training in clinical research methods including biostatistics, responsible research conduct, clinical epidemiology, and design and implementation of research studies. The scientific component of the proposal is focused on the primary prevention of sudden cardiac death. Sudden cardiac death remains a common clinical problem in the United States, with over 350,000 deaths annually. Patients with left ventricular systolic dysfunction are at particularly high risk for the ventricular arrhythmias that precipitate sudden cardiac death. The goal of this research is to develop a new method to identify those patients with systolic dysfunction who are most likely to suffer malignant ventricular arrhythmias. If a high-risk subgroup can be identified, these patients are likely to benefit from prophylactic treatment with an implantable cardioverter-defibrillator (ICD). This proposal is focused on the development of two novel risk stratification techniques that independently quantify dynamic changes in ventricular repolarization: T wave variability and T wave alternans. The scientific program will test the following hypotheses: 1) T wave variability and T wave alternans are both predictors of arrhythmic events among patients with ischemic cardiomyopathy. 2) Patients with increased T wave variability derive a greater mortality benefit from prophylactic ICD implantation.