Prognostic significance of T wave variability

描述（由申请人提供）： 此应用程序的总体目标是支持 研究者在以患者为导向的研究中的职业发展。 为了实现这一目标，拟议的方案既有培训， 科学成分。培训部分将包括教学内容， 课程和书面论文的准备，最终在硕士学位， 临床研究理学学位。这个创新的学位课程是 由流行病学和预防医学系提供， 马里兰州大学。该课程将提供临床培训 研究方法，包括生物统计学，负责任的研究行为， 临床流行病学，以及研究的设计和实施。的 建议的科学部分侧重于初级预防， 心源性猝死心源性猝死仍是临床常见问题 在美国，每年有超过35万人死亡。病左 心室收缩功能障碍的风险特别高， 导致心脏性猝死的室性心律失常。的目标 这项研究旨在开发一种新的方法来识别那些患有 收缩功能障碍者最有可能患恶性心室肌病变 心律不齐如果可以确定一个高风险亚组，这些患者是 可能受益于植入式 心律转复除颤器（ICD）。该提案的重点是发展 两种新的风险分层技术， 心室复极的动态变化：T波变异性和T波 交替科学计划将测试以下假设：1）T 波的变异性和T波交替都是脑卒中事件的预测因子 缺血性心肌病患者中。2)T升高的患者 波形变异性从预防性ICD中获得更大的死亡率获益 置入

DESCRIPTION (provided by applicant): The overall objective of this application is to support the principal investigator's development in a career focused on patient-oriented research. To accomplish this objective, the proposed program has both training and scientific components. The training component will consist of didactic coursework and preparation of a written thesis, culminating in a Master of Science degree in Clinical Investigation. This innovative degree program is offered by the Department of Epidemiology and Preventive Medicine at the University of Maryland. The coursework will provide training in clinical research methods including biostatistics, responsible research conduct, clinical epidemiology, and design and implementation of research studies. The scientific component of the proposal is focused on the primary prevention of sudden cardiac death. Sudden cardiac death remains a common clinical problem in the United States, with over 350,000 deaths annually. Patients with left ventricular systolic dysfunction are at particularly high risk for the ventricular arrhythmias that precipitate sudden cardiac death. The goal of this research is to develop a new method to identify those patients with systolic dysfunction who are most likely to suffer malignant ventricular arrhythmias. If a high-risk subgroup can be identified, these patients are likely to benefit from prophylactic treatment with an implantable cardioverter-defibrillator (ICD). This proposal is focused on the development of two novel risk stratification techniques that independently quantify dynamic changes in ventricular repolarization: T wave variability and T wave alternans. The scientific program will test the following hypotheses: 1) T wave variability and T wave alternans are both predictors of arrhythmic events among patients with ischemic cardiomyopathy. 2) Patients with increased T wave variability derive a greater mortality benefit from prophylactic ICD implantation.