Applications of Magnetic Resonance for Management of Ventricular Tachycardia

磁共振在室性心动过速治疗中的应用

基本信息

  • 批准号:
    7787035
  • 负责人:
  • 金额:
    $ 13.29万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2010
  • 资助国家:
    美国
  • 起止时间:
    2010-03-02 至 2015-02-28
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): I am interested in clinical translation of new methodologies for risk stratification and therapy of patients with ventricular tachycardia (VT). My proposed career development plan incorporates patient-oriented research guided by the mentorship of Dr. Henry R. Halperin, with a doctoral program in clinical epidemiology under the mentorship of Dr. Neil R. Powe. Dr. Halperin has extensive experience in technology development for magnetic resonance imaging (MRI) guided electrophysiology. As a member of Dr. Halperin's laboratory during fellowship, I used myocardial scar imaging and characterization techniques for identification of the substrate for inducible VT in patients with non-ischemic cardiomyopathy. This technique has since been validated by other groups, and was later shown to identify non-ischemic cardiomyopathy patients at high risk of sudden death. However, the benefits of such an approach remain unassessed in many other high-risk patient subsets. Even upon identification of high-risk patients, current treatments for VT are not ideal. Implantable defibrillators cause painful shocks and decrease quality of life, and catheter ablation is associated with failures deriving from the inability to visualize the VT substrate with fluoroscopy. The central hypothesis of this proposal is that scar (substrate) visualization via MRI can improve the risk stratification and therapy of VT. The aims of my research proposal are to 1) Examine the utility of MRI for detection of the VT substrate in another high risk population and 2) Examine the efficacy of pre-acquired three-dimensional MRI scar map integration for substrate based VT ablation versus standard VT ablation. Importantly, the clinical focus of my aims is complementary, but distinct, from Dr. Halperin's focus on technology development. Successful clinical translation of such technology will require comprehensive study of the functional electrophysiology correlates of various scar morphologies on imaging, and assessment of effectiveness and safety outcomes. The necessity of successful clinical translation of our technologic advances has shaped my career development and research aims and will help me achieve investigative independence. To properly address these aims we will require sophisticated epidemiologic, study design, and biostatistical techniques. To this end, I have enrolled in the doctoral clinical epidemiology program at the Johns Hopkins Bloomberg School of Public Health. Dr. Powe, an expert in epidemiology and outcomes research, will oversee my training in clinical epidemiology. My other mentor, Dr. Brian S. Caffo is an expert in biostatistics and medical imaging. Translation of new methodologies for risk stratification and treatment of patients with ventricular arrhythmia has the potential to impact public health significantly. I look forward to the opportunity to contribute to this important research while developing expertise and investigative independence in clinical research, through the resources of this proposal. PUBLIC HEALTH RELEVANCE: The aim of this proposal is to enhance the career development of the candidate through: 1) a didactic doctoral program in clinical epidemiology and 2) patient oriented research in magnetic resonance imaging techniques for risk stratification and catheter ablation of ventricular tachycardia. It is estimated that sudden cardiac death accounts for up to 15 percent of the total mortality in the United States. Translation of new methodologies for risk stratification and treatment of ventricular arrhythmia may allow earlier recognition and more effective treatment for patients at high risk of sudden death, and has the potential to impact public health significantly. (End of Abstract)
描述(由申请人提供):我对室性心动过速(VT)患者风险分层和治疗新方法的临床转化感兴趣。我提出的职业发展计划包括在亨利博士的指导下以病人为导向的研究。Halperin博士在Neil R. - 是的Halperin博士在磁共振成像(MRI)引导的电生理学技术开发方面拥有丰富的经验。作为Halperin博士实验室的一员,我使用心肌瘢痕成像和表征技术来识别非缺血性心肌病患者诱导性室性心动过速的底物。这项技术已经被其他研究小组验证,后来被证明可以识别猝死风险高的非缺血性心肌病患者。然而,这种方法的益处在许多其他高风险患者亚群中仍未评估。即使在识别出高风险患者后,目前对VT的治疗也不理想。植入式起搏器会引起疼痛性电击并降低生活质量,导管消融术与无法通过荧光透视观察VT基底而导致的失败相关。该建议的中心假设是通过MRI显示瘢痕(基质)可以改善VT的风险分层和治疗。我的研究提案旨在:1)检查MRI在另一个高风险人群中检测VT基质的效用; 2)检查预先获取的三维MRI瘢痕图整合在基于基质的VT消融术与标准VT消融术中的有效性。重要的是,我的目标的临床重点是互补的,但不同的,从博士Halperin的技术开发的重点。这种技术的成功临床转化将需要对成像上各种瘢痕形态的功能电生理学相关性进行全面研究,并评估有效性和安全性结局。我们的技术进步的成功临床翻译的必要性已经形成了我的职业发展和研究目标,并将帮助我实现研究的独立性。为了正确地实现这些目标,我们需要复杂的流行病学,研究设计和生物统计技术。为此,我报名参加了约翰霍普金斯布隆伯格公共卫生学院的临床流行病学博士课程。Dr. Jesus是流行病学和结果研究方面的专家,他将监督我在临床流行病学方面的培训。我的另一位导师,布莱恩·S博士。Caffo是生物统计学和医学成像方面的专家。室性心律失常患者风险分层和治疗新方法的转化有可能对公共卫生产生重大影响。我期待着有机会为这项重要的研究做出贡献,同时通过本提案的资源,发展临床研究的专业知识和调查独立性。 公共卫生关系: 该提案的目的是通过以下方式促进候选人的职业发展:1)临床流行病学的教学博士课程和2)针对室性心动过速风险分层和导管消融的磁共振成像技术的患者导向研究。据估计,心脏性猝死占美国总死亡率的15%。室性心律失常的风险分层和治疗的新方法的翻译可能允许更早地识别和更有效地治疗猝死高危患者,并有可能对公共卫生产生重大影响。 (End摘要)

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(1)

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Saman Nazarian其他文献

Saman Nazarian的其他文献

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{{ truncateString('Saman Nazarian', 18)}}的其他基金

Implications of Intra-Myocardial Fat Deposition upon Propensity for Malignant Arrhythmia
心肌内脂肪沉积对恶性心律失常倾向的影响
  • 批准号:
    10249267
  • 财政年份:
    2018
  • 资助金额:
    $ 13.29万
  • 项目类别:
Implications of Intra-Myocardial Fat Deposition upon Propensity for Malignant Arrhythmia
心肌内脂肪沉积对恶性心律失常倾向的影响
  • 批准号:
    9762217
  • 财政年份:
    2018
  • 资助金额:
    $ 13.29万
  • 项目类别:
ANCILLARY STUDY OF SUBSTRATE AND INTERVENTION MECHANISMS FOR MALIGNANT ARRHYTHMIA
恶性心律失常的底物及干预机制的辅助研究
  • 批准号:
    8894566
  • 财政年份:
    2013
  • 资助金额:
    $ 13.29万
  • 项目类别:
ANCILLARY STUDY OF SUBSTRATE AND INTERVENTION MECHANISMS FOR MALIGNANT ARRHYTHMIA
恶性心律失常的底物及干预机制的辅助研究
  • 批准号:
    9119158
  • 财政年份:
    2013
  • 资助金额:
    $ 13.29万
  • 项目类别:
ANCILLARY STUDY OF SUBSTRATE AND INTERVENTION MECHANISMS FOR MALIGNANT ARRHYTHMIA
恶性心律失常的底物及干预机制的辅助研究
  • 批准号:
    8714041
  • 财政年份:
    2013
  • 资助金额:
    $ 13.29万
  • 项目类别:
ANCILLARY STUDY OF SUBSTRATE AND INTERVENTION MECHANISMS FOR MALIGNANT ARRHYTHMIA
恶性心律失常的底物及干预机制的辅助研究
  • 批准号:
    8549491
  • 财政年份:
    2013
  • 资助金额:
    $ 13.29万
  • 项目类别:
Applications of Magnetic Resonance for Management of Ventricular Tachycardia
磁共振在室性心动过速治疗中的应用
  • 批准号:
    8037718
  • 财政年份:
    2010
  • 资助金额:
    $ 13.29万
  • 项目类别:
Applications of Magnetic Resonance for Management of Ventricular Tachycardia
磁共振在室性心动过速治疗中的应用
  • 批准号:
    8234203
  • 财政年份:
    2010
  • 资助金额:
    $ 13.29万
  • 项目类别:
Applications of Magnetic Resonance for Management of Ventricular Tachycardia
磁共振在室性心动过速治疗中的应用
  • 批准号:
    8611808
  • 财政年份:
    2010
  • 资助金额:
    $ 13.29万
  • 项目类别:
Applications of Magnetic Resonance for Management of Ventricular Tachycardia
磁共振在室性心动过速治疗中的应用
  • 批准号:
    8441621
  • 财政年份:
    2010
  • 资助金额:
    $ 13.29万
  • 项目类别:

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