Inflammation & Prognosis in Decompensated Heart Failure

炎

• 批准号: 6868910
• 负责人: GARY M FELKER
• 金额: $ 15.11万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6868910
• 关键词: acute phase protein; binding proteins; biomarker; cardiovascular disorder risk; clinical research; heart failure; human subject; inflammation; interleukin 6; mathematical model; outcomes research; patient oriented research; prognosis; tumor necrosis factor alpha

Decompensated heart failure (DHF) is among the most common indications for hospitalization in the United States, and continues to increase in incidence with the increasing prevalence of heart failure and the aging of the population. Despite the substantial impact of this clinical syndrome, the ability to prospectively risk stratify patients DHF lags far behind that of other comparable cardiovascular disorders. Inflammation has been shown to play an important role in chronic heart failure, but its importance in DHF is unknown. The broad objectives of this proposal focus on defining optimal risk stratification strategies in DHF and on integrating measures of inflammation with traditional clinical data in order to predict future adverse events. Additionally, the project will seek to define the response of serologic markers of inflammation to current therapies and the relationship of that response to subsequent patient outcomes. These aims will be accomplished through a prospective cohort study of patients hospitalized with DHF. Successful completion of these aims will contribute to accurate risk stratification of patients with DHF and to the understanding of the role of inflammation in the transition from a compensated to decompensated clinical syndrome. This research will form the core of a 5-year career development plan for Dr. Michael Felker under the mentorship of Dr. Christopher O'Connor, a nationally recognized expert in patient oriented research in heart failure. They propose a career development plan that combines didactic training in research methodology, active collaboration with basic investigators, and ongoing clinical research experience within the unique research environment of the Duke Clinical Research Institute. In conjunction with carefully selected collaborators, this career development plan will foster Dr. Felker's development into an established independent clinical investigator with expertise in both complex clinical research methodology and the role of inflammation in the pathophysiology of heart failure.

失代偿性心力衰竭(DHF)是美国最常见的住院指征之一，随着心力衰竭患病率的增加和人口老龄化，DHF的发病率持续上升。尽管这种临床综合征有很大的影响，但对DHF患者进行前瞻性风险分层的能力远远落后于其他可比的心血管疾病。炎症已被证明在慢性心力衰竭中起重要作用，但其在DHF中的重要性尚不清楚。这项建议的广泛目标集中在确定DHF的最佳风险分层策略，并将炎症测量与传统临床数据相结合，以便预测未来的不良事件。此外，该项目将寻求确定炎症的血清标志物对当前治疗的反应，以及这种反应与后续患者结局的关系。这些目标将通过对DHF住院患者进行前瞻性队列研究来实现。这些目标的成功完成将有助于对DHF患者进行准确的风险分层，并有助于理解炎症在从代偿性临床综合征向失代偿性临床综合征过渡过程中的作用。这项研究将构成迈克尔·费尔克博士在克里斯托弗·奥康纳博士指导下的5年职业发展计划的核心。克里斯托弗·奥康纳博士是全国公认的以患者为导向的心力衰竭研究专家。他们提出了一项职业发展计划，将研究方法方面的教学培训、与基础研究人员的积极合作以及在杜克临床研究所独特的研究环境中不断进行的临床研究经验结合起来。与精心挑选的合作者一起，这一职业发展计划将促进费尔克博士发展成为一名成熟的独立临床研究员，在复杂的临床研究方法和炎症在心力衰竭病理生理学中的作用方面都具有专业知识。