In-Vivo Electrophysiology Imaging

摘要 心律失常是发病率和死亡率的主要原因，超过25万人死亡 每年突然在美国。大多数心律失常是后天性的，是由于心脏 心脏或其电系统的缺血，梗塞，心脏手术，病毒，和各种非- 心脏病我们识别哪些患者猝死风险最高的能力很差， 射血分数是唯一可用于危险分层的主要临床工具。此外，本发明还提供了一种方法， 对于高风险患者，放置内部心律转复除颤器（ICD）是唯一有效的治疗方法。 因此，识别用于研究体内心律失常和分层药物风险的新工具将 代表了心血管护理的重大进步。 在先锋奖的资助下，我们将开发两种新颖和革命性的技术， 来成像体内完整心脏的电活动。首先，我们将采用最常见的临床 成像技术，二维多普勒超声心动图，以检测真实的时间的电活动。 其次，我们将开发一种改良的自体干细胞植入物，以检测肾上腺素能活性， 心这些技术将在体外开发，使用动物模型在体内测试，并应用于 人类，如果可能的话。如果成功，这两种技术将增加我们对心律失常的了解 机制，改善猝死风险患者的风险分层，并指导治疗 干预措施。

Abstract Arrhythmias are a major cause of morbidity and mortality, with more than 250,000 people dying suddenly each year in the United States. Most arrhythmias are acquired and result from damage to the heart or its electrical system by ischemia, infarction, cardiac surgery, viruses, and assorted non- cardiac diseases. Our ability to identify which patients are at the highest risk of sudden death is poor, with ejection fraction being the only major clinical tool available for risk stratification. In addition, internal cardioverter-defibrillator (ICD) placement is the only effective therapy for high risk patients. Thus, the identification for novel tools to study arrhythmias in-vivo and stratify arrhythmic risk would represent a major advance to cardiovascular care. With the funding from the Pioneer Award, we will develop two novel and revolutionary techniques to image electrical activity in the intact heart in-vivo. First, we will adapt the most common clinical imaging technique, two-dimensional doppler echocardiography, to detect electrical activity in real time. Second, we will develop a modified autologous stem cell implant to detect adrenergic activity in the heart. These techniques will be developed in-vitro, tested in-vivo using animal models, and applied to humans when possible. If successful, both techniques will increase our understanding of arrhythmia mechanisms, improve risk stratification in patients at risk for sudden death, and guide therapeutic interventions.