QUANTITATIVE CARDIAC PHYSIOLOGY IN CLINICAL CARDIOLOGY

这一修订申请的中期职业研究者奖在病人为导向的研究侧重于定量心脏生理学在临床心脏病学。目标是在多学科临床研究中指导年轻的研究者，旨在最大限度地提取有用的信息。申请人已建立指导记录。1991年，他创立了华盛顿大学心血管生物物理实验室，部分目的是为面向患者的研究提供培训和假设测试场所。学员将接触到正在进行的研究，使用新的方法来探索人类疾病的机制（充血性心力衰竭，收缩和舒张功能障碍）和阐明生理学（四室心功能）。主要研究主题包括：基于模型的图像处理（MBIP）的多普勒超声心动图舒张功能评估；心脏MRI测定四室平衡容积；并通过相平面分析进行血流动力学表征。本质上多学科的方法包括临床、认知和定量工具，用于检验因果和相关假设。受训者的支持是通过心血管部门的培训补助金（NIH: 5-T32-HL07081， M.E. Cain， PI）。他们将通过获取和处理多通道生理数据来制定需要心脏生理学定量表征的假设，并通过应用统计方法和确定临床相关性来验证这些假设。作为研究计划的一部分，描述了一个已完成的、资助的、回顾性的试点项目及其自然的预期扩展，受训人员将参与其中。描述了受训者将参与的假设项目及其自然的前瞻性延伸。经检验的假设是，与传统超声心动图指标（EF、减速时间）相比，MBIP（一种新方法）产生的舒张功能多普勒衍生指标更能反映住院的老年心力衰竭患者1年死亡率。

This revised application for a Midcareer Investigator Award in Patient- Oriented Research focuses on quantitative cardiac physiology in clinical cardiology. The goal is to mentor young investigators in multi- disciplinary clinical investigation aimed at maximizing the amount of useful information extracted. The applicant has an established record of mentoring. In 1991 he founded Washington University's Cardiovascular Biophysics Laboratory in part to serve as a training and hypothesis- testing venue for patient-oriented research. Trainees will be exposed to ongoing investigations that use novel methods to explore mechanisms of human disease (congestive heart failure, systolic and diastolic dysfunction) and elucidate physiology (four-chamber heart function). Main themes of investigations include: diastolic function assessment by Doppler echocardiography via model-based image processing (MBIP); four chamber equilibrium volume determination by cardiac MRI; and hemodynamic characterization by phase-plane analysis. The intrinsically multi-disciplinary methods include clinical, cognitive, and quantitative tools for testing causal and correlative hypotheses. Trainees' support is via the Cardiovascular Division's training grant (NIH: 5-T32-HL07081, M.E. Cain, PI). They will formulate hypotheses that require quantitative characterization of cardiac physiology via acquisition and processing of multi-channel physiological data, and test them via application of statistical methods and determination of clinical correlates. As part of the Research Plan, one completed, funded, retrospective pilot project and its natural prospective extension are described in which trainees will participate. The hypothesis project and its natural prospective extension are described in which trainees will participate. The hypothesis tested is that Doppler derived indexes of diastolic function generated by MBIP (a novel approach) are better indicators of 1-year mortality in selected elderly patients admitted to the hospital with heart failure than are conventional echocardiographic indexes (EF, deceleration time) from the same Doppler data.