? The broad, long-term objective of this proposal is for the candidate to become a productive, independent patient-oriented investigator. This proposal details a five-year multidisciplinary career development program of patient-oriented investigation centered on cardiac magnetic resonance imaging (MRI). The health relatedness of the proposal is the clinical implementation of new imaging methods that will surmount current deficiencies in cardiac MRI methods; specifically, image artifacts and low signal to noise ratio. Therefore, the proposal aims to provide a more widespread application of MRI. One application of the new imaging methods is the evaluation of myocardial delayed enhancement which can be used to determine myocardial viability. Since the volume of viable myocardium is a critical factor in determining the subset of patients with ischemic heart disease who will benefit from surgery, achieving the most accurate estimate of viable myocardium is an important imaging goal. The program has three core components: coursework, clinical training, and clinical research. The proposed coursework component would be performed at the Harvard School of Public Health and is designed to provide training to include research fundamentals necessary to perform clinical trials. The proposed clinical training component would encompass all aspects of clinical cardiac MRI and would provide a unique opportunity for subspecialized clinical MRI practice. The clinical research component proposes to design, implement, and test in clinical trials innovative cardiac MRI methods. Three new imaging strategies are described, as are the potential advantages and disadvantages of each. These strategies will achieve the goal of minimizing image artifacts and maximizing cardiac MRI signal, and one strategy will be optimized for the three-dimensional assessment of myocardial delayed enhancement. The proposed research career development award would be performed in an environment particularly supportive of young patient-oriented investigators. Under the supervision of the experienced mentor and co-mentors, the candidate would have a unique career development opportunity that utilizes the extensive educational, clinical, and research resources of the supporting institution. ? ?
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