Midcareer Mentoring Award for Patient Oriented Research in Geriatric Cardiology

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影响老年人，包括心脏功能保留的心力衰竭，并在指导住院医师，心脏病学研究员和老年病学和心脏病学的初级教师方面取得了成功的记录。申请人的职业规划是将他的研究兴趣扩展到与年龄相关的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，主要影响老年人。在该奖项的任期内，申请人将通过梅尔曼公共卫生学院的正式课程获得遗传学方面的进一步培训，加强与哥伦比亚大学基础和临床研究人员的现有合作关系，并建立新的合作关系，并为老年病学和心脏病学的年轻临床研究人员建立一个成功的指导计划，以促进跨学科合作研究。后者将通过创建大纽约老年心脏病学联合会（GNYGCC）来实现，该联合会旨在通过组织和提供老年心脏病学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、研究者发起的、多中心合作临床调查，改善老年心血管疾病患者的护理。建议的指导计划包括三个其他组成部分：1)以患者为导向的研究的强化个性化培训；2)哥伦比亚大学临床试验设计、数据分析、拨款撰写和伦理方面的教学项目；3)由以患者为导向的研究专家团队进行严格审查。在面向患者的研究中授予职业中期研究者奖将为实现这些职业目标提供急需的保护时间。哥伦比亚大学为申请人的职业发展提供了强有力的制度环境。内科和心脏科承诺保护申请人e50%的时间用于患者导向的研究和指导。提出的目的是评估：(1)靶向贫血（可导致HFNEF综合征的众多心外因素之一）是否与心室功能、功能容量和健康状况的改善有关。(2)通过保持或降低射血分数分层分析导致或促进心力衰竭患者无能（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活动描记术分析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，并提供一种机制，使受训人员能够获得必要的技能，以开展研究事业和收集数据，以支持赠款申请。最终目标是促进心脏病学和老年病学新一代研究人员的发展，他们可以在衰老心血管疾病领域进行临床研究。

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.