Functional MR in Ischemic Cardiomyopathy

功能性磁共振在缺血性心肌病中的应用

• 批准号: 7497238
• 负责人: Paul A Grayburn
• 金额: $ 23.66万
• 依托单位: BAYLOR RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7497238
• 关键词: Acute myocardial infarction; Address; Adverse effects; Anatomy; Ancillary Study; Animal Model; Animals; Anterior; Biometry; Cardiomyopathies; Cicatrix; Clinical; Clinical Trials; Complication; Coronary; Coronary Artery Bypass; Dilated Cardiomyopathy; Echocardiography; Etiology; Exclusion; Failure; Genetic screening method; Heart failure; Knowledge; Laboratories; Left; Left Ventricular Ejection Fraction; Left Ventricular Remodeling; Link; Magnetic Resonance Imaging; Medical; Mitral Valve Insufficiency; Myocardial; Myocardial Infarction; Myocardial Ischemia; Numbers; Operative Surgical Procedures; Outcome; Patients; Principal Investigator; Prospective Studies; Quality of life; Radionuclide Imaging; Randomized; Research Design; Series; Severities; Symptoms; Transesophageal Echocardiography; Ventricular; concept; day; design; improved; mortality; outcome forecast; programs; repaired; response; restoration; size

Functional mitral regurgitation (MR) is a common complication of ischemic heart disease. Two large clinical trials confmned an adverse effect of functional MR on survival after a heart attack. However, studies in heart failure are small and mainly limited to patients with nonischemic cardiomyopathy. Recent animal studies have challenged the traditional concept that functional MR is a consequence of mitral annular dilation, instead suggesting that functional MR is due to leaflet tethering by outward expansion of the left ventricular wall (i.e. LV remodeling). This has critical implications regarding the correct surgical approach to correcting functional MR. To date, no large prospective studies have examined the mechanism(s) of functional MR in ischemic cardiomyopathy, nor has the interaction between mechanism and prognosis been explored. This is a crucial knowledge gap because 1) 70% of heart failure cases are caused by ischemic heart disease, and 2) functional MR occurs in around 60% of patients with ischemic cardiomyopathy. This proposal aims to fill these gaps by defining the mechanism(s) of functional MR by transesophageal echocardiography in a large clinical trial of patients with ischemic cardiomyopathy. The following specific aims will be addressed: Aim 1: To define the mechanism(s) of functional MR in isehemie cardiomyopathy Aim 2: To define the effect of therapy on mechanism and severity of functional MR Aim 3: To evaluate the effect of functional MR on prognosis is ischemic cardiomyopathy Aim 4: To evaluate the effect of myocardial viability on functional MR and its response to treatment. We propose to accomplish these aims as an ancillary study to the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. The STICH Trial will compare surgical revaseularization versus medical therapy for treatment of heart failure in 2800 patients with ischemic cardiomyopathy, and therefore affords a unique opportunity to investigate the mechanism(s) of functional MR. Despite its known clinical utility for assessing the mechanism and severity of MR, TEE is not currently included in STICH.

Functional mitral regurgitation (MR) is a common complication of ischemic heart disease. Two large clinical trials confmned an adverse effect of functional MR on survival after a heart attack. However, studies in heart failure are small and mainly limited to patients with nonischemic cardiomyopathy. Recent animal studies have challenged the traditional concept that functional MR is a consequence of mitral annular dilation, instead suggesting that functional MR is due to leaflet tethering by outward expansion of the left ventricular wall (i.e. LV remodeling). This has critical implications regarding the correct surgical approach to correcting functional MR. To date, no large prospective studies have examined the mechanism(s) of functional MR in ischemic cardiomyopathy, nor has the interaction between mechanism and prognosis been explored. This is a crucial knowledge gap because 1) 70% of heart failure cases are caused by ischemic heart disease, and 2) functional MR occurs in around 60% of patients with ischemic cardiomyopathy. This proposal aims to fill these gaps by defining the mechanism(s) of functional MR by transesophageal echocardiography in a large clinical trial of patients with ischemic cardiomyopathy. The following specific aims will be addressed: Aim 1: To define the mechanism(s) of functional MR in isehemie cardiomyopathy Aim 2: To define the effect of therapy on mechanism and severity of functional MR Aim 3: To evaluate the effect of functional MR on prognosis is ischemic cardiomyopathy Aim 4: To evaluate the effect of myocardial viability on functional MR and its response to treatment. We propose to accomplish these aims as an ancillary study to the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. The STICH Trial will compare surgical revaseularization versus medical therapy for treatment of heart failure in 2800 patients with ischemic cardiomyopathy, and therefore affords a unique opportunity to investigate the mechanism(s) of functional MR. Despite its known clinical utility for assessing the mechanism and severity of MR, TEE is not currently included in STICH.

项目成果

A new method for generating insulin-secreting cells from human pancreatic epithelial cells after islet isolation transformed by NeuroD1.

• DOI: 10.1089/hgtb.2013.122
• 发表时间: 2014-05
• 期刊: Human gene therapy methods
• 作者: M. Shimoda;Shuyuan Chen;H. Noguchi;M. Takita;K. Sugimoto;T. Itoh;D. Chujo;S. Iwahashi;B. Naziruddin;M. Levy;S. Matsumoto;P. Grayburn