Cardiovascular disease is the major cause of morbidity and mortality in the United States. It is anticipated that by 2020 it will become the major cause of death in the world, surpassing infectious disease for the first time. At the same time, increasing longevity in the developed world is contributing to a greater prevalence of this disease despite major advances in its prevention and treatment. The sheer number of patients with different forms of cardiovascular disease makes it logistically impossible to use invasive procedures to make a diagnosis. The need for noninvasive methods to detect early disease has therefore never been as crucial. Technical advances in cardiovascular imaging have resulted in their increased use over the years. Nuclear cardiology and echocardiography are now mature technologies that are commonly used in clinical practice. Magnetic Resonance Imaging (MRI) as well as helical CT has also started to play a role in the clinical assessment of cardiovascular disease. Nonetheless, the number of physicians and other technical personnel who have in-depth expertise in these fields is sadly lacking. In most cardiology training programs, increased emphasis on invasive procedures results in the production of trainees with a very superficial knowledge of noninvasive imaging. Even if a trainee spends a substantial amount of time in noninvasive laboratories, they are likely to develop expertise in only one of the imaging modalities. The University of Virginia is one of a handful of centers in the U.S. that have high-level expertise in all forms of cardiac imaging as well as a track record of training physicians in these modalities. Many of these physicians are currently full time in academics and are running their own experimental or clinical laboratories. The purpose of this grant proposal is to develop a research training program that will provide comprehensive training in all three modalities: nuclear cardiology, echocardiography, and MRI with particular emphasis placed on coronary artery disease, which is the primary research interest of all the faculty who will participate in the training program. Equal emphasis will be placed on the technical aspects of imaging as well as on physiology and pathophysiology. The ultimate aim is to train individuals who will become tomorrow's academic leaders in cardiovascular imaging.
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