Renal Sympathetic Denervation in Congestive Heart Failure

充血性心力衰竭中的肾交感神经去神经支配

• 批准号: 8198004
• 负责人: Randall Carson Starling
• 金额: $ 36.11万
• 依托单位: CLEVELAND CLINIC LERNER COM-CWRU
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8198004
• 关键词: Activities of Daily Living; Acute; Area; Cardiac; Cardiovascular Diseases; Catheters; Clinic; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Collaborations; Community Hospitals; Congestive Heart Failure; Development; Diagnosis; Enrollment; Environment; Evaluation; Functional disorder; Goals; Heart failure; Hospitals; Hypertension; Incidence; Institution; Institutional Review Boards; Instruction; Investigation; Joints; Kidney; Lead; Leadership; Measurement; Mediating; Medical center; Natriuresis; Natriuretic Peptides; Nerve; Outcome; Participant; Patients; Performance; Phase; Principal Investigator; Process; Production; Prospective Studies; Randomized Clinical Trials; Recruitment Activity; Refractory; Renal function; Research; Research Infrastructure; Research Personnel; Research Subjects; Role; Safety; Sympathectomy; Symptoms; Syndrome; System; Techniques; Testing; Therapeutic; Translational Research; Tubular formation; Universities; University Hospitals; aging population; base; design; experience; hemodynamics; improved; interest; medical schools; meetings; novel; novel strategies; novel therapeutics; outreach; patient population; tool; treatment as usual

DESCRIPTION (provided by applicant): This proposal represents a joint effort combining the vast infrastructure, extensive clinical and research experience, as well as large patient volumes in heart failure at the Cleveland Clinic, together with the clinical trial expertise and diverse patient populations at University Hospitals and MetroHealth Medical Center to establish the Cleveland Regional Clinical Center (RCC). Led by Drs. W. H. Wilson Tang and Randall C. Starting and joined by Drs. James Fang and Mark Dunlap as co-investigators, and taking advantage of the Cleveland Clinical and Translational Sciences Collaborative (CTSC) that recently integrated the research infrastructure our three institutions, our goal is to participate n the Heart Failure Clinical Research Network to test new hypotheses and therapies to advance the management of heart failure. In particular, we hope to expand our longstanding academic interest in developing strategies to alleviate cardio-renal compromise in congestive heart failure. Our proposed project serves as a mechanistic study to discern the possible role of renal sympathetic nerves in mediating cardiac and/or renal complications of the cardio-renal syndrome. Utilizing a novel, catheter-based renal sympathetic denervation (RSD) technique currently under investigation for treatment of refractory hypertension (Symplicity Catheter System), we test the hypothesis that in patients with hypertensive heart failure recently admitted for congestive heart failure that RSD may provide incremental improvement in neurohormonal profile, improve cardio-renal function, and facilitate symptomatic relief over usual care. Our consortium provides a unique opportunity to contribute to the overall Network with clinical trials expertise and leadership in heart failure to fulfill the scientific requirements, and the diverse ad broad regional patient populations across a wide range of practice settings with proven abilities to recruit and fulfill the performance requirements, and to test a novel treatment approach to tackle one of the most challenging aspects of contemporary heart failure. RELEVANCE (See instructions): The incidence of heart failure continues to increase in large due to the expansion of the aging population and therapeutic advances in the management of acute cardiovascular diseases. The presence of cardio-renal dysfunction constitutes a major impediment to adequate management of heart failure, and further understanding and novel strategies to relieve cardio-renal compromise is a priority to improve outcomes.

描述（由申请人提供）：该提案代表了一项联合努力，结合了克利夫兰诊所的庞大基础设施、广泛的临床和研究经验以及大量心力衰竭患者，以及大学医院和MetroHealth医疗中心的临床试验专业知识和多样化患者人群，以建立克利夫兰区域临床中心（RCC）。由W博士领导。H. Wilson Tang和Randall C. James Fang和Mark Dunlap博士作为合作研究者开始并加入，并利用克利夫兰临床和转化科学合作组织（CTSC），该组织最近整合了我们三个机构的研究基础设施，我们的目标是参与心力衰竭临床研究网络，以测试新的假设和疗法，以推进心力衰竭的管理。特别是，我们希望扩大我们长期以来的学术兴趣，发展战略，以减轻充血性心力衰竭的心肾损害。 我们建议的项目作为一个机制的研究，以辨别肾交感神经介导的心肾综合征的心脏和/或肾脏并发症的可能作用。利用一种新的，基于导管的肾交感神经去神经（RSD）技术，目前正在研究治疗难治性高血压（Symplicity导管系统），我们测试的假设，在高血压性心力衰竭患者最近入院的充血性心力衰竭，RSD可以提供增量改善神经激素的配置文件，改善心肾功能，并促进症状缓解超过常规护理。我们的联盟提供了一个独特的机会，通过临床试验专业知识和心力衰竭方面的领导力为整个网络做出贡献，以满足科学要求，并在广泛的实践环境中为多样化和广泛的区域患者人群做出贡献，这些患者人群具有公认的招募和满足性能要求的能力，并测试一种新的治疗方法，以解决当代心力衰竭最具挑战性的方面之一。 相关性（参见说明）：由于人口老龄化的扩大和急性心血管疾病治疗的进展，心力衰竭的发病率持续大幅增加。心肾功能不全的存在构成了心力衰竭充分管理的主要障碍，进一步了解和缓解心肾损害的新策略是改善结局的优先事项。