Inflammation & Prognosis in Decompensated Heart Failure

失代偿性心力衰竭（DHF）是美国最常见的住院适应症之一，随着心力衰竭患病率的增加和人口老龄化，其发病率持续增加。尽管这种临床综合征的影响很大，但对DHF患者进行前瞻性风险分层的能力远远落后于其他类似的心血管疾病。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。该提案的广泛目标集中于定义DHF的最佳风险分层策略，并将炎症指标与传统临床数据相结合，以预测未来的不良事件。此外，该项目将寻求确定炎症血清学标志物对当前治疗的反应以及该反应与后续患者结局的关系。这些目标将通过DHF住院患者的前瞻性队列研究实现。这些目标的成功完成将有助于DHF患者的准确风险分层，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转变中的作用。这项研究将成为Michael Felker博士在Christopher奥康纳博士指导下的5年职业发展计划的核心，Christopher O'Connor博士是全国公认的心力衰竭患者导向研究专家。他们提出了一个职业发展计划，结合教学培训的研究方法，积极与基础研究人员的合作，并在杜克临床研究所的独特的研究环境正在进行的临床研究经验。与精心挑选的合作者一起，这个职业发展计划将促进Felker博士发展成为一名成熟的独立临床研究者，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具有专业知识。

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.