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

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)
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会议论文数量(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:
Genetics of Hypoplastic Left Heart Syndrome
左心发育不良综合征的遗传学
  • 批准号:
    9324048
  • 财政年份:
    2015
  • 资助金额:
    $ 75.27万
  • 项目类别:
Genetics of Hypoplastic Left Heart Syndrome
左心发育不良综合征的遗传学
  • 批准号:
    9114658
  • 财政年份:
    2015
  • 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
  • 资助金额:
    $ 75.27万
  • 项目类别:

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