RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patients
重新激活 FONTAN - 随机运动干预旨在最大限度地提高儿童 FONTAN 患者的健康状况
基本信息
- 批准号:9893292
- 负责人:
- 金额:$ 75.27万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-03-10 至 2021-02-28
- 项目状态:已结题
- 来源:
- 关键词:19 year oldAccelerometerAdherenceAdmission activityAdolescentAdolescent and Young AdultAdolescent obesityAdultAerobicAgeAngiotensin ReceptorAngiotensin-Converting Enzyme InhibitorsArginineBiological MarkersBrain natriuretic peptideCardiacCardiopulmonaryCessation of lifeChemicalsChildChild HealthChildhoodChronicCommon VentricleCreatineDataDisease ProgressionDual-Energy X-Ray AbsorptiometryEchocardiographyEffectivenessEndotheliumEquipment and supply inventoriesExerciseExercise stress testGoalsHealthHeartHeart TransplantationHeart failureInterventionLegMagnetic Resonance ImagingMeasuresMissionModalityModelingMorbidity - disease rateMovementMuscle MitochondriaMuscle functionNitratesNitric OxideNitric Oxide PathwayNitritesObesityOutcomePatientsPhysical CapacityPhysical FunctionPhysical activityPhysiologic pulsePlasmaPopulationQuality of lifeQuestionnairesRandomizedRandomized Clinical TrialsRandomized Controlled TrialsReproducibilityResearchResistanceRiskScanningSchoolsSiteSupervisionTestingThinnessTranslationsTransplant RecipientsTransportationTreatment FailureUnited States National Institutes of HealthVO2maxWorkYouthadherence ratearmcardiorespiratory fitnessclinical applicationcongenital heart disorderdesignendothelial dysfunctionevidence baseexercise capacityexercise interventionexercise prescriptionfitnessheart functionimprovedimproved outcomeindexingmortalitymultidisciplinarymuscle formmuscle strengthneonatal periodnovelnovel strategiesnovel therapeutic interventionpalliationphysical conditioningpreventprimary outcomereduced muscle masssuccesssymposiumtherapy designtreatment as usual
项目摘要
PROJECT SUMMARY
Survival of children with single ventricles (“half a heart”) beyond the neonatal period has increased dramatically
with the staged Fontan palliation. Yet, long-term morbidity remains high. By the age of 40, 50% of Fontan patients
will have died or undergone heart transplantation. With >1,000 Fontan palliations performed in the US annually,
there is a burgeoning population of Fontan patients at risk for progressive heart failure and death. Factors that
contribute to onset and progression of heart failure in Fontan patients remain incompletely understood. However,
it is established that Fontan patients have poor exercise capacity, associated with a greater risk of morbidity and
mortality, in addition to decreased muscle mass, abnormal muscle function, and endothelial dysfunction
contributing to disease progression. In adult patients with two ventricles and heart failure, reduced exercise
capacity, muscle mass, and muscle strength are powerful predictors of poor outcomes, and exercise
interventions can not only improve exercise capacity and muscle mass, but also reverse endothelial dysfunction.
Limited exercise interventions in children with congenital heart disease have demonstrated that exercise is safe
and effective; however, these studies have been conducted in small, heterogeneous groups, and most had few
Fontan patients. Furthermore, none of these interventions have studied the impact of exercise on muscle mass
or mitochondrial function, or endothelial function. We propose a milestone-driven, randomized controlled
trial in pediatric Fontan patients to test the hypothesis that a live-video-supervised exercise (aerobic +
resistance) intervention will improve cardiac and physical capacity; muscle mass, strength and function;
and endothelial function. Adherence is a major limitation in pediatric exercise interventions delivered on-site,
with adherence rates as low as 10%, due to distance from site, transportation difficulties, and missed school or
work days. To overcome these challenges, we will utilize live-video conferencing to deliver the supervised
exercise sessions. In our pilot exercise interventions, this approach resulted in excellent adherence (>85%)
and improved exercise capacity and endothelial function. This proposal is designed to determine if the
intervention improves: (Aim 1) cardiac and physical capacity (primary outcome: VO2 max), (Aim 2) muscle mass
strength and function; and (Aim 3) endothelial function in pediatric Fontan patients. Our multidisciplinary team of
experts will assess the effectiveness of a live-video-supervised exercise intervention, rigorously designed to
maximize adherence and improve key and novel measures of health in pediatric Fontan patients associated with
poor long-term outcomes. The use of exercise as a non-pharmacologic treatment modality in pediatric Fontan
patients represents a paradigm shift, where standard therapies have failed. Our ultimate goal is the translation
of this model to clinical application as an ”exercise prescription” to intervene early in pediatric Fontan patients
and decrease long-term morbidity and mortality, in alignment with the NIH’s mission to develop evidence-based
data for new approaches to improve outcomes in youth with chronic conditions.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Daniel Bernstein其他文献
Daniel Bernstein的其他文献
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{{ truncateString('Daniel Bernstein', 18)}}的其他基金
RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patients
重新激活 FONTAN - 随机运动干预旨在最大限度地提高儿童 FONTAN 患者的健康状况
- 批准号:
10589103 - 财政年份:2020
- 资助金额:
$ 75.27万 - 项目类别:
RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patients
重新激活 FONTAN - 随机运动干预旨在最大限度地提高儿童 FONTAN 患者的健康状况
- 批准号:
10378166 - 财政年份:2020
- 资助金额:
$ 75.27万 - 项目类别:
RE-ENERGIZE FONTAN - RandomizEd Exercise INtERvention desiGned to MaximIZE Fitness in Pediatric FONTAN patients
重新激活 FONTAN - 随机运动干预旨在最大限度地提高儿童 FONTAN 患者的健康状况
- 批准号:
10274780 - 财政年份:2020
- 资助金额:
$ 75.27万 - 项目类别:
From proteins to cells to tissues: A multi-scale assessment of biomechanical regulation by the myosin molecular motor
从蛋白质到细胞再到组织:肌球蛋白分子马达生物力学调节的多尺度评估
- 批准号:
10291393 - 财政年份:2019
- 资助金额:
$ 75.27万 - 项目类别:
From proteins to cells to tissues: A multi-scale assessment of biomechanical regulation by the myosin molecular motor
从蛋白质到细胞再到组织:肌球蛋白分子马达生物力学调节的多尺度评估
- 批准号:
10396504 - 财政年份:2019
- 资助金额:
$ 75.27万 - 项目类别:
From proteins to cells to tissues: A multi-scale assessment of biomechanical regulation by the myosin molecular motor
从蛋白质到细胞再到组织:肌球蛋白分子马达生物力学调节的多尺度评估
- 批准号:
10584005 - 财政年份:2019
- 资助金额:
$ 75.27万 - 项目类别:
From proteins to cells to tissues: A multi-scale assessment of biomechanical regulation by the myosin molecular motor
从蛋白质到细胞再到组织:肌球蛋白分子马达生物力学调节的多尺度评估
- 批准号:
10615077 - 财政年份:2019
- 资助金额:
$ 75.27万 - 项目类别:
hiPSC-Cardiomyocytes to Screen Variants Predictive of Doxorubicin Cardiotoxicity
hiPSC-心肌细胞筛选预测阿霉素心脏毒性的变异体
- 批准号:
8909180 - 财政年份:2014
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$ 75.27万 - 项目类别:
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