IDENTIFICATION AND TREATMENT OF AUTONOMIC AND ELECTROPHYSIOLOGIC ALTERATIONS

这项计划的长期目标是调查 心源性猝死的致心律失常机制 冠心病和心室肥厚患者，两名 在每年30万的突发事件中，精神障碍占绝大多数 美国的心脏死亡。我们的总体主题是结构性 影响细胞间通讯的心肌异常 导致电生理障碍的致命性 室性快速性心律失常。其中一些反常现象，曾经 确定、可以更正或修改，并相应减少 冒着心律不齐的危险。我们假设自主神经 系统是细胞间通信的重要调制器，且 了解其角色将提供对以下事件的洞察 突然导致心源性猝死，让人理解 心肌底物，用于识别有风险的患者，并进入 选择治疗方案。我们计划进行一系列研究，调查 自主神经的侵袭性和非侵袭性分布 正常心脏、冠状动脉疾病患者和 心脏肥厚。我们计划给人以同情和迷茫的形象 使用正电子发射断层扫描的心肌模式。这些临床 研究将与动物实验密切相关。它是 预计这一项目的成果将扩大我们对 正常和异常的心脏自主神经支配如何产生或 预防心律失常和心源性猝死。

The long-term objectives of this project are to investigate the arrhythmogenic mechanisms responsible for sudden cardiac death in patients with coronary heart disease and ventricular hypertrophy, two disorders accounting for the vast majority of the 300,000 annual sudden cardiac deaths in the U.S. Our overall theme is that structural abnormalities of the myocardium that affect cell-to-cell communication lead to electrophysiological disturbances responsible for the fatal ventricular tachyarrhythmia. Some of these abnormalities, once identified, can be corrected or modified, with a corresponding decrease in the risk of arrhythmia. We hypothesize that the autonomic nervous system is an important modulator of cell-to-cell communication and that understanding its role will provide insight into the events that precipitate sudden cardiac death, into understanding the receptive myocardial substrate, into identifying the patients at risk, and into selecting therapeutic options. We plan a series of studies investigating autonomic innervation invasively and noninvasively in individuals with normal hearts, those with coronary artery disease and patients with ventricular hypertrophy. We plan to image sympathetic and vagal myocardial patterns using positron emission tomography. These clinical studies will be tied very closely with the animal experiments. It is anticipated that the result of this project will expand our knowledge of how normal and abnormal autonomic cardiac innervation produces or prevents cardiac arrhythmias and sudden cardiac death.