IDENTIFICATION AND TREATMENT OF AUTONOMIC AND ELECTROPHYSIOLOGIC ALTERATIONS

该项目的长期目标是研究导致冠心病和心室肥厚患者心脏性猝死的致心律失常机制，这两种疾病占美国每年30万例心脏性猝死的绝大多数。我们的总体主题是，影响细胞间通讯的心肌结构异常导致导致致命性室性快速性心律失常的电生理障碍。这些异常中的一些一旦被发现，就可以被纠正或修改，从而相应地降低心律失常的风险。我们假设自主神经系统是细胞间交流的重要调节器，了解其作用将有助于深入了解导致心脏性猝死的事件，从而选择治疗方案。我们计划进行一系列研究，以侵入性和非侵入性的方式研究心脏正常者、冠心病患者和室壁肥厚患者的自主神经支配。我们计划使用正电子发射断层扫描技术对交感和迷走神经心肌模式进行成像。预计该项目的结果将扩大我们对正常和异常自主神经支配如何产生或预防心律失常和心脏性猝死的了解。

The long term objectives of this project are to investigate the arrhymogenic mechanisms responsible for sudden cardiac death in patients with coronary 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 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. It is anticipated that the results of this project will expand our knowledge of how normal and abnormal autonomic cardiac innervation produces or prevents cardiac arrhythmias and sudden cardiac death.