QUANTITATIVE CARDIAC PHYSIOLOGY IN CLINICAL CARDIOLOGY

这个修订后的申请职业中期研究者奖在以病人为导向的研究重点是定量心脏生理学在临床心脏病学。其目标是指导年轻的研究人员在多学科的临床调查，旨在最大限度地提高有用的信息提取量。申请人有一个既定的指导记录。1991年，他建立了华盛顿大学心血管生物物理学实验室，部分目的是作为面向患者的研究的培训和假设检验场所。学员将接触到正在进行的调查，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（四腔心功能）。研究的主要主题包括：通过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;通过心脏MRI确定四腔平衡容积;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，用于测试因果关系和相关假设。学员的支持是通过心血管部门的培训补助金（NIH：5-T32-HL 07081，M.E. Cain，PI）。他们将通过采集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测试这些假设。作为研究计划的一部分，一个已完成的，资助，回顾性试点项目及其自然的前瞻性扩展描述了学员将参加。假设项目及其自然的前瞻性扩展中描述的学员将参与。检验的假设是，与来自相同多普勒数据的常规超声心动图指标（EF，减速时间）相比，由MBIP（一种新方法）生成的多普勒衍生舒张功能指标是选择的因心力衰竭入院的老年患者1年死亡率的更好指标。

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.