Mid Atlantic Heart Failure Network

这是来自宾夕法尼亚大学医学院的一份参与心脏研究的申请 失败临床研究网络(HF-CRN)作为区域临床中心(RCC)和临床研究 技能发展核心。我们的中大西洋RCC包括约翰·霍普金斯大学和兰卡斯特心脏 组。作为一个综合体，我们的网站遵循了超过6,000名患者的不同人口统计 心力衰竭(HF)，有1900多人新转诊，18000人次门诊，2900人次心力衰竭 每年住院治疗。现有心力衰竭患者群体和转诊基础的规模和多样性 由我们的网站提供的服务将使我们的RCC能够识别和招募几乎任何类型的HF临床患者 研究性学习。通过这一应用，我们提出了一项新的临床试验，以检验阿司匹林的疗效。 重组胰高血糖素样肽(GLP-1)在重度收缩期心衰患者中的应用认识到最近 研究表明，30%的死亡率或再次住院以及多次住院失败 干预措施，我们的研究将医院内登记的后勤优势与医院后登记的需要结合在一起 住院干预。GLP-1的治疗前景是基于这样的假设：失败的 心脏受到生物能量的挑战，数据表明两者的心肌胰岛素抵抗都很高 糖尿病患者和非糖尿病患者合并严重的收缩心衰。已发表的小型研究表明，GLP-1 改善慢性心功能不全患者的心肌功能和预后 心力衰竭、急性心肌梗死和冠状动脉旁路移植术进一步支持了安全性和 GLP-1的潜在疗效。这些试验中的每一项都由医学主席理查德·香农博士领导 在宾夕法尼亚大学，他将担任这一申请的顾问。在360名随机患者中，拟议的研究 将研究GLP-1对死亡或反复住院的主要终点的影响，以及几个 通过多巴酚丁胺负荷评估包括心肌收缩储备在内的次要终点 超声心动图，6分钟步行距离，生活质量。GLP-1在高危人群中的新研究 非常适合HF-CRN的组织和力量。 相关性(请参阅说明)： 心力衰竭是美国人死亡的主要原因，它给美国带来了重大的公共健康和经济问题 负担。因心力衰竭住院的患者预后不良的风险尤其大。通过评估有希望的 临床干预，包括胰高血糖素样肽(GLP-1)，建议建立新的区域 NHLBI心力衰竭网络临床中心将有助于改善心力衰竭患者的护理。

This is an application from the University of Pennsylvania School of Medicine to participate in the Heart Failure Clinical Research Network (HF-CRN) as a regional clinical center (RCC) and as a Clinical Research Skills Development Core. Our Mid-Atlantic RCC includes Johns Hopkins University and the Lancaster Heart Group. As a composite, our sites follow a demographically diverse population of more than 6,000 patients with heart failure (HF), with more than 1,900 new referrals, 18,000 outpatient visits and 2,900 HF hospitalizations annually. The size and diversity of the existing HF patient population and referral base served by our sites will enable our RCC to identify and enroll patients in virtually any type of HF clinical research study. With this application, we propose a novel clinical trial examining the therapeutic efficacy of recombinant glucagon-like peptide (GLP-1) in patients with severe systolic HF. Recognizing that recent studies demonstrate a 30% rate of death or re-hospitalization and the failure of multiple in-hospital interventions, our study couples the logistical advantages of in-hospital enrollment with the need for a post- hospitalization intervention. The therapeutic promise of GLP-1 is based on the hypothesis that the failing heart is challenged bioenergetically and date indicating that myocardial insulin resistance is high among both diabetics and non-diabetics with severe systolic HF. Small published studies demonstrating that GLP-1 improves myocardial performance and outcomes in patients with systolic dysfunction associated with chronic heart failure, acute myocardial infarction and coronary bypass grafting further support the safety and potential efficacy of GLP-1. Each of these trials was led by Dr. Richard Shannon, the Chairman of Medicine at Penn, who will serve as a consultant for this application. In 360 randomized patients, the proposed study will examine the effect of GLP-1 on the primary endpoint of death or recurrent hospitalization and several secondary endpoints including myocardial contractile reserve assessed via dobutamine stress echocardiography, 6-minute walk distance, quality of life. This novel study of GLP-1 in a high risk population is well-suited to the organization and strength of the HF-CRN. RELEVANCE (See instructions): Heart failure is a leading cause of mortality in the U.S. that imposes a major public health and financial burden. Patients hospitalized with HF are at particular risk for poor outcomes. By evaluating promising clinical interventions, including glucagon-like peptide (GLP-1), this proposal to establish a new regional clinical center for the NHLBI Heart Failure Network will help improve the care of patients with heart failure.