From 7d1fdd54a70d804d02b1e1938473cfa21974b5ee Mon Sep 17 00:00:00 2001 From: Brian Date: Fri, 1 Mar 2019 15:50:35 -0700 Subject: [PATCH] random --- 18-12-12-Proposal/Latex/aims.tex | 37 -------------------------------- 1 file changed, 37 deletions(-) diff --git a/18-12-12-Proposal/Latex/aims.tex b/18-12-12-Proposal/Latex/aims.tex index 5351f04..acd3454 100644 --- a/18-12-12-Proposal/Latex/aims.tex +++ b/18-12-12-Proposal/Latex/aims.tex @@ -18,43 +18,6 @@ \section{Specific Aims} develops from inadequate perfusion of myocardial tissue and indicates the presence of coronary artery disease, ischemic heart disease, or other potentially fatal cardiac diseases. Current noninvasive tests to detect -ischemia may be limited by incoischemia under different forms of cardiac stress. - - \item [Aim 3:] \textbf{Test the hypothesis that ECG imaging techniques -E160024 - -%\end{itemize} -%\end{numlist} - - -Success in this project will lead to improvements -in detection and clinical diagnosis of myocardial ischemia using ECGI -techniques validated with experimental data. Our experimental -approach will be valuable for various cardiac modeling applications, -including validation studies for other ECGI techniques. By comparing -exercise and pharmacological stress at the fine scale, our experiments will be the first high-resolution analysis and will increase our understanding of myocardial ischemia development -to guide the -interpretation of clinical stress tests. Finally, as we detect ischemia -early and accurately, we will limit patient burden and increase therapeutic -success. Conducting these studies in this rich -mentoring environment will ensure deep exposure to all aspects of research -and facilitate my development as an independent physician scientist. - -%Paragraph 4: Success in this endeavor will have immediate and profound -%effects on the millions of patients who suffer from this disease. -%Moreover, our hypothesis suggest a novel mechanism for the development of -%the disease that will open new opportunities for therapeutic interventions. - - - -%\end{document} - -%Despite the increased understanding of electrical indicators within myocardial ischemia, where myocardial tissue supply of nutrients is less than the amount needed for normal heart function, little is understood about how to clinically identify these parameters. Current tests used to detect these electrical changes are induced via exercise stressing the heart and recording electrical changes. Yet the most sensitive tests for myocardial ischemia, pharmacological stress testing with combined ultrasound imaging, have shown little to no change in common ischemia defining electrical indicators. With the confirmed identification of ischemia, but no indication via electrical indicators, healthcare professionals largely disregard potentially key information about heart status and dismiss their possible value as a diagnostic tool. To continue our advancement in understanding of ischemia, and improve diagnostic testing and identification, this disparity of detection between different tests must be addressed. - -%This limited understanding of the electrical signals that indicate myocardial ischemia hinder our ability to adequately diagnose and treat patients suffering - -%Despite recent advances in cardiac treatment, undetected myocardial ischemia remains a high cause of mortality in the United States. Ischemia is a condition where the myocardial tissue's demand for nutrients is larger than the available supply. Myocardial ischemia plays a role in decreasing heart function, development of heart failure, and inducing fatal cardiac arrhythmias. Knowing these consequences, physicians and health care professionals attempt to detect ischemia using several different methods such as exercise stress testing, nuclear imaging, or pharmacological stress testing. Despite the multitude of testing, ischemia While each test is used to detect ischemia, electrical indicators of myocardial ischemia vary greatly depending on the test. Although the clinical community recognizes this variation, little is understood about why it exists. Insights into these differences may provide new information in detecting and diagnosing myocardial ischemia to help mitigate and prevent long term damage. - %Pharmacological stress tests use drugs, typically dobutamine, to induce cardiac stress by increasing heart rate and cardiac muscle contraction force. Myocardial ischemia is detected during these pharmacological stress tests by ultrasound imaging or echocardiography alone neglecting a key cardiac function indicator, heart electrical cardiac signals. Most analysis of myocardial electrical signals have been dismissed for perceived decreased sensitivity compared to imaging. However, detection of myocardial ischemia via pharmacological stress testing sensitivity and specificity decent at best with many cases of ischemia not detected. In addition, echocardiography is a complicated task requiring several experts and increased resources to detect ischemic indicators.