Mentoring and Patient-Oriented Research on Electrocardiographic Digital Biomarkers of Psychological Stress and Cardiovascular Disease

About This Grant

Project Summary Dr. Shah is a clinician-scientist with a focus on cardiovascular disease (CVD) heart-brain mechanisms and digital biomarkers, aiming to address the critical intersection between psychological stress and autonomic health. This K24 Mid-Career Investigator Award will support Dr. Shah in expanding research on sympathetic nervous system (SNS) activity and its role in both CVD risk and mental illness. This award will also provide resources to mentor junior clinical investigators and public health students in these areas. It will also provide Dr. Shah with the necessary training in advanced signal processing and analytics to work collaboratively with his various engineering collaborators. Dr. Shah has a strong record of mentoring trainees and contributing to cardiovascular research programs at Emory University, including the NHLBI-funded T32 training grant on cardiovascular health disparities. The mentorship component will focus on the design and execution of patient- oriented research projects in stress physiology and wearable technology, as well as on fostering independence in trainees pursuing careers in cardiovascular research. The study will leverage ongoing studies including Smart Health and Rehabilitation Technology (HEART) which will involve enrolling 300 veterans in cardiac rehabilitation and the Myocardial Infarction and Mental Stress 3 (MIMS3) cohort (R01 HL109413), which includes 306 post-myocardial infarction (MI) participants who underwent mental stress provocation with ECG monitoring and long-term follow-up. Specifically, Dr. Shah and his engineering collaborators will perform innovative analysis of the multi-channel ECG to examine periodic repolarization dynamics (PRD), a novel ECG-based biomarker of SNS activity that measures the low frequency spectral power of beat-to-beat changes in the spatial T-wave axis. The specific research aims of this project are: (1) to evaluate changes in PRD in response to mental stress and after therapeutic lifestyle modification; (2) to assess the association of PRD with mental health conditions, including depression and post-traumatic stress disorder (PTSD); and (3) to examine the relationship between PRD and long-term CVD outcomes, such as heart failure, myocardial infarction, and CVD-related mortality. This award will enable Dr. Shah to continue developing innovative research on digital biomarkers and autonomic health, while strengthening the mentorship pipeline for cardiovascular research. This will ultimately contribute to preventing adverse cardiovascular outcomes through both scientific discovery and the development of future investigators.