Mechanisms of Air Pollution Health Effects in Subjects with Heart Failure

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DESCRIPTION (provided by applicant) Dr. Gregory Wellenius's long-term career goal is to be become an independent investigator capable of leading patient-oriented research efforts in environmental cardiology. During the mentored (K99) phase of this career development award, the candidate will gain expertise in conducting patient-oriented mechanistic research in the setting of the General Clinical Research Center, assessment of vascular endothelial function, statistical methodology, and exposure assessment. The candidate will also establish his own laboratory, collect preliminary data, and refine power calculations during this phase. Dr. Murray Mittleman, the candidate's current post-doctoral mentor, will serve as primary mentor and oversee all aspects of the candidate's training. In addition, a team of three co-mentors with complimentary areas of expertise will supplement Dr. Wellenius's training in specific areas. Together, the mentor and co-mentors are committed to assisting the candidate reach his research training and career development goals and to ensuring the candidate's successful transition from postdoctoral fellow to independent researcher. During the independent (R00) phase of this award, the candidate will conduct a prospective, repeated-measures study to evaluate the mechanisms by which particulate air pollution affects autonomic function, inflammation, and vascular endothelial function in a cohort of patients with congestive heart failure. These putative mechanisms have been evaluated in a number of normal and susceptible populations, but never specifically in subjects with congestive heart failure. Relevance: Hospitalization rates among patients with congestive heart failure are extremely high. Epidemiologic studies suggest that short-term increases in ambient air pollution are associated with increased risk of hospitalization in this population, but the mechanisms of this effect have not been investigated. Understanding the underlying mechanisms may lead to new preventative strategies, new treatments, or improved air quality.