In-Vivo Electrophysiology Imaging

摘要 心律失常是发病率和死亡率的主要原因，有超过25万人死亡 在美国，每年突然。大多数心律失常都是后天性的，是由于 心脏或其电子系统因缺血、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风险分层的主要临床工具。此外, 对于高危患者，放置心脏复律除颤器(ICD)是唯一有效的治疗方法。 因此，识别新的工具来研究体内心律失常并对心律失常风险进行分层将 代表着心血管护理的一大进步。 在先锋奖的资助下，我们将开发两种新颖和革命性的技术 在活体内成像完整心脏的电活动。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，实时检测电活动。 其次，我们将开发一种改良的自体干细胞植入物来检测肾上腺素能活动 心。这些技术将在体外开发，在体内使用动物模型进行测试，并应用于 在可能的情况下是人类。如果成功，这两种技术都将增加我们对心律失常的理解 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.