Midcareer Mentoring Award for Patient Oriented Research in Geriatric Cardiology

产品说明：申请人的学术生涯证明了对以患者为导向的研究的长期承诺，在年龄相关心血管疾病的病理生理学研究方面的广泛专业知识，这些疾病不成比例地折磨老年人，包括心脏收缩功能保留的心力衰竭，以及指导居民，心脏病学研究员和老年病和心脏病学初级教师的成功记录。申请人的职业规划是将其研究兴趣扩展到年龄相关心血管疾病的多学科研究，重点关注射血分数正常的心力衰竭，这占美国心力衰竭病例的一半以上，主要困扰老年人。在此奖项的任期内，申请人将获得进一步的培训，通过正式的课程在公共卫生的梅尔曼学院遗传学，加强现有的和形成新的合作关系与基础和临床研究人员在哥伦比亚大学，并建立一个成功的指导计划，为年轻的临床研究人员从老年病和心脏病，这将促进合作的跨学科研究。后者将通过创建大纽约老年心脏病联合会（GNYGCC）来实现，该联合会旨在通过组织和提供老年心脏病课程作为专业医学教育活动的一部分，并随后通过开展创新的、由医生发起的多中心协作临床研究，改善对患有心血管疾病的老年成年患者的护理。拟议的指导计划包括三个其他组成部分：1）密集的个性化培训，以病人为导向的研究; 2）哥伦比亚大学的教学计划，临床试验设计，数据分析，赠款写作，和伦理; 3）由一个小组的关键审查以病人为导向的研究专家。在以患者为导向的研究中授予职业中期研究者奖将提供急需的保护时间来实现这些职业目标。哥伦比亚为申请人的职业发展提供了强大的制度环境。内科和心脏科的部门已承诺保护e50%的申请人的时间为patientoriented研究和指导。拟评价：（1）靶向贫血（可能导致HFNEF综合征的许多心外因素之一）是否与改善心室功能、功能能力和健康状况相关。(2)在心力衰竭受试者中，通过射血分数保留或降低分层，了解导致或促成无运动力（缺乏能量）的病理生理机制的潜在差异;（3）在接受经皮主动脉瓣置换术的老年人中，使用无创压力容积分析和体动仪进行心室力学和功能容量。拟议的研究将促进申请人的职业发展，并提供一个机制，使学员能够获得必要的技能，以开始研究生涯，并收集数据，以支持补助金申请。最终目标是促进新一代心脏病学和老年医学研究者的发展，他们可以在老年心血管疾病的竞技场进行临床研究。 公共卫生相关性：心血管疾病仍然是美国死亡的主要原因，大多数受影响的人是老年人。该计划的广泛目标是培养下一代学术临床心血管研究人员，他们将专注于不成比例地折磨老年人的心血管疾病，以改善这些人的结果。

DESCRIPTION: The applicant's academic career demonstrates a longterm commitment to patientoriented research, extensive expertise in the study of the pathophysiology of age related cardiovascular disorders that disproportionately afflict older adults including heart failure with preserved systolic function and a successful record in mentoring residents, cardiology fellows and junior faculty in geriatrics and cardiology. The career plan of the applicant is to expand his research interests to multidisciplinary studies of age related cardiovascular conditions by focusing on heart failure with a normal ejection fraction, which accounts for more than half of the cases of heart failure in the United States and that afflicts predominately older adults. During the tenure of this award, the applicant will gain further training in genetics through formal coursework at the Mailman School of Public Health, strengthen existing and form new collaborative relationships with basic and clinical investigators at Columbia University, and institute a successful mentoring program for young clinical investigators from geriatrics and cardiology that will foster collaborative interdisciplinary investigations. The latter will be achieved by the creation of the Greater New York Geriatric Cardiology Consortium (GNYGCC) aimed at improving the care of older adult patients with cardiovascular disease by organizing and delivering a curriculum in geriatric cardiology as part of professional medical education activities and subsequently by performing innovative, investigatorinitiated, multicenter collaborative clinical investigation. The proposed mentoring program consists of three other components: 1) intensive individualized training in patientoriented research; 2) Columbia University didactic programs on clinical trial design, data analysis, grant writing, and ethics; 3) critical review by a team of patient oriented research experts. Awarding a Midcareer Investigator Award in Patient Oriented Research will provide critically needed protected time to achieve these career goals. Columbia provides a strong institutional environment for support of the applicant's career development. The Department of Internal Medicine and Division of Cardiology have committed to protect e50% of the applicant's time for patientoriented research and mentoring. The proposed aims are to evaluate: (1) whether targeting anemia, one of many extracardiac factors that could contribute to the syndrome of HFNEF, is associated with improved ventricular function, functional capacity and health status. (2) for potential differences in pathophysiologic mechanisms that cause or contribute to anergia (lack of energy) in heart failure subjects stratified by a preserved or a reduced ejection fraction and (3) ventricular mechanics and functional capacity using use of noninvasive pressure volume analysis and actigraphy in older adults undergoing percutaneous aortic valve replacement. The proposed studies will advance applicant career development and provide a mechanism by which trainees can acquire the necessary skills to launch a research career and collect data to support grant applications. The ultimate goal is to facilitate the development of a new generation of investigators from both cardiology and geriatrics that can pursue clinical research in the arena of aging cardiovascular disease. PUBLIC HEALTH RELEVANCE: Cardiovascular Disease remains the leading cause of mortality in the United States with a majority of those afflicted being older adults. The broad goal of this program is to train the next generation of academic clinical cardiovascular investigators who will focus on cardiovascular disorders that disproportionately afflict older adults in order to improve the outcomes among these individuals.