QUANTITATIVE CARDIAC PHYSIOLOGY IN CLINICAL CARDIOLOGY

这份修订后的以患者为中心的研究生涯中期研究人员奖的申请重点是临床心脏病学中的定量心脏生理学。其目标是在多学科临床调查中指导年轻的研究人员，旨在最大限度地提取有用的信息量。申请人有既定的指导记录。1991年，他创建了华盛顿大学的心血管生物物理实验室，部分原因是作为以患者为导向的研究的培训和假设检验场所。受训者将接触到正在进行的研究，这些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、收缩和舒张期功能障碍)并阐明生理学(四腔心功能)。主要研究内容包括：基于模型图像处理(MBIP)的多普勒超声心动图评价舒张期功能；心脏MRI测定四腔平衡容量；相平面分析血流动力学特征。从本质上讲，多学科方法包括临床、认知和量化工具，用于检验因果和相关假设。学员的支持是通过心血管科的培训资助(NIH：5-T32-HL07081，M.E.凯恩，PI)。他们将通过获取和处理多通道生理数据来制定需要定量描述心脏生理学的假设，并通过应用统计方法和确定临床相关性来检验这些假设。作为研究计划的一部分，描述了一个完成的、资助的、有追溯性的试点项目及其自然的预期扩展，受训人员将参加该项目。描述了受训者将参与的假设项目及其自然的预期延伸。测试的假设是，与来自相同多普勒数据的传统超声心动图指数(EF，减速时间)相比，由MBIP(一种新方法)产生的多普勒衍生的舒张期功能指数是入院治疗的心力衰竭患者中更好的一年死亡率指标。

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.