Effectiveness of Indoor Air Purifiers on Heart Failure Outcomes (The PURI-HF Trial)

室内空气净化器对心力衰竭结果的有效性（PURI-HF 试验）

• 批准号: 10286556
• 负责人: NITISH NAIK
• 金额: $ 33.9万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-25 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10286556
• 关键词: Activities of Daily Living; Acute; Adverse effects; Air; Air Pollution; Arrhythmia; Blood Pressure; Caliber; Cancer Control; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic; Cities; Clinical; Cost Effectiveness Analysis; Country; Diabetes Mellitus; Disease; Disease Outcome; EFRAC; Effectiveness; Environmental Health; Environmental Impact; Environmental Risk Factor; Evaluation; Exposure to; Health; Heart failure; Hospitalization; Household; Human; Incidence; India; Indoor Air Pollution; Institutes; Intervention; Knowledge; Link; Long-Term Effects; Mediating; Mediation; Mediator of activation protein; Medical; Morbidity - disease rate; Outcome; Participant; Particulate Matter; Patients; Pollution; Prevention program; Principal Investigator; Process; Quality of life; Randomized Controlled Trials; Recommendation; Research; Research Personnel; Research Training; Risk Factors; Science; Site; Statistical Data Interpretation; Stroke; Techniques; Test Result; Testing; Walking; air filter; ambient air pollution; cardiovascular health; cooking; effectiveness evaluation; experience; fine particles; high efficiency particulate air filter; human subject; improved; innovation; low and middle-income countries; medical schools; mortality; portability; programs; therapy design; training opportunity; ventilation

Project Abstract: Effectiveness of Indoor Air Purifiers on Heart Failure Outcomes (PURI-HF Trial) Indoor air pollution is one of the leading risk factors for global mortality, with over 90% of pollution-related deaths occurring in low- and middle- income countries (LMICs). Fine mode particulate matter with an aerodynamic diameter smaller than 2.5 micrometers (PM2.5) is a major contributor to global morbidity and mortality, particularly due to cardiovascular disease (CVD). There is a strong link between both acute and chronic PM2.5 air pollution exposure and heart failure (HF) incidence, hospitalizations, and mortality. Most recommendations to reduce air pollution-mediated CVD have focused on improved cooking techniques and ventilation, but with mixed results. New strategies to improve air quality and cardiovascular health are needed. For the past few decades, high-efficiency particulate air (HEPA) purifiers have been studied in LMICs to decrease PM2.5 pollution and improve health outcomes. However, there remain substantial gaps in understanding the long-term effects of air purifiers on functional and clinical HF outcomes. We are an established group of investigators with a successful track record of innovative and impactful studies at the intersection of air pollution and CVD. We will leverage our experience to study the impact of an innovative approach to reduce the adverse impact of air pollution and improve HF outcomes in India. The PURI-HF Trial aims to demonstrate the efficacy, feasibility and effectiveness of portable air filters in improving indoor PM2.5 levels and improving functional capacity of HF patients with reduced ejection fraction (HFrEF) in India. Our proposed partnership between NYU Grossman School of Medicine and All India Institute of Medical Sciences will emphasize capacity building and cross-institutional training opportunities throughout the duration of the project. Aim 1 will be a randomized controlled trial to evaluate the effectiveness of indoor air purifiers on HF functional capacity (6-minute walk test) among patients with HReEF in Delhi, Ludhiana, and Thiruvananthapuram. We will also conduct a moderation analysis to evaluate whether level of ambient air pollution, as well as spatial/environmental factors, moderate the impact of air purifiers on HF outcomes. Aim 2 will involve a causal mediation analysis to determine if the reduction in PM2.5 is associated with the relationship between air purifiers and HF outcomes. We will also assess whether seasonality correlates with the reduction in indoor PM2.5 concentrations in participant households, and we will determine the impact of air purifier use on the composition of PM2.5 air pollution in the three study sites. Aim 3 will be comprised of a cost-effectiveness analysis and process evaluation of the intervention. The research will be conducted by a transdisciplinary research team with diverse and complementary expertise led by two experienced Principal Investigators. We intend to add to existing knowledge of innovative and scalable strategies to improve environmental and cardiovascular health worldwide.

项目摘要：室内空气净化器对心力衰竭结果的有效性（PURI-HF 试验） 室内空气污染是全球死亡的主要风险因素之一，超过 90% 的死亡与污染有关 死亡发生在低收入和中等收入国家 (LMIC)。精细模式颗粒物 空气动力学直径小于 2.5 微米 (PM2.5) 是全球发病率和 死亡率，特别是心血管疾病（CVD）引起的死亡率。急性和急性之间有很强的联系。 慢性 PM2.5 空气污染暴露与心力衰竭 (HF) 发病率、住院率和死亡率。最多 减少空气污染介导的CVD的建议重点是改进烹饪技术 和通风，但结果好坏参半。改善空气质量和心血管健康的新策略是 需要。在过去的几十年里，高效颗粒空气 (HEPA) 净化器的研究已在以下领域进行： 中低收入国家减少 PM2.5 污染并改善健康状况。但仍存在巨大差距 了解空气净化器对功能性和临床心力衰竭结果的长期影响。我们是一家 建立了一个研究小组，在创新和有影响力的研究方面拥有成功的记录 空气污染与CVD的交叉点。我们将利用我们的经验来研究创新的影响 减少印度空气污染的不利影响并改善心力衰竭结果的方法。 PURI-HF 试验旨在证明便携式空气过滤器在改善空气质量方面的功效、可行性和有效性 室内 PM2.5 水平和改善射血分数降低的心衰患者 (HFrEF) 的功能能力 在印度。我们提议纽约大学格罗斯曼医学院和全印度研究所之间建立合作伙伴关系 医学科学将在整个过程中强调能力建设和跨机构培训机会 项目的持续时间。目标 1 将是一项随机对照试验，以评估以下方法的有效性： 室内空气净化器对德里 HReEF 患者的 HF 功能能力（6 分钟步行测试）的影响， 卢迪亚纳和特里凡得琅。我们还将进行调节分析来评估水平是否 环境空气污染以及空间/环境因素减轻了空气净化器对空气的影响 心力衰竭结果。目标 2 将涉及因果中介分析，以确定 PM2.5 的减少是否有效 与空气净化器和心衰结果之间的关系有关。我们还将评估是否 季节性与参与家庭室内 PM2.5 浓度的降低相关，并且 我们将在三项研究中确定空气净化器的使用对PM2.5空气污染成分的影响 网站。目标 3 将包括干预措施的成本效益分析和过程评估。 该研究将由一个跨学科研究团队进行，该团队具有多元化和互补性 由两位经验丰富的首席研究员领导的专业知识。我们打算增加现有的知识 改善全球环境和心血管健康的创新和可扩展战略。