Racial/Ethnic Disparities in Heart Failure: A Cross Cohort Collaboration

摘要 心力衰竭（HF）及其亚型，定义为保留型（HFpEF）、减少型（HFrEF）或中度（HFmrEF） 射血分数是一个主要的和日益严重的公共健康问题。该项目的长期目标是更好地 了解关于HF的健康差异，并确定有效的预防措施， 这些差异。我们建议从10项大型纵向队列研究中汇总数据，以检查种族/民族 和性别差异在发展HF，其亚型，其预后。统一的数据将包括超过 130，028名男性和女性，超过8975例类似裁定的前瞻性HF结局，代表了广泛的 美国的年龄、种族/民族和地理区域范围。这种跨队列 合作将提供一个独特的机会，对性别和种族/族裔进行全面评估， HF中的健康差异。因果中介分析技术将用于估计 单因素和多因素生活方式和临床干预可能会减少HF的健康差异。在我们 表型作图的目的，我们将根据队列数据定义HF的独特临床相关表型， 还通常存在于医疗记录中以增强概括性，包括年龄，种族/民族，性别， 临床体征、症状、生物标志物、射血分数、生理指标和合并症;我们还将 评估HF表型与CVD和全因死亡率的相关性。

ABSTRACT Heart failure (HF), and its subtypes defined by preserved (HFpEF), reduced (HFrEF) or mid-range (HFmrEF) ejection fraction are a major and growing public health problem. The long term goal of this project is to better understand the health disparities regarding HF and define effective preventive measures that may reduce these disparities. We propose to pool data from 10 large longitudinal cohort studies to examine race/ethnic and sex disparities in developing HF, its subtypes, and its prognosis. The harmonized data will include over 130,028 men and women with over 8975 similarly-adjudicated prospective HF outcomes, representing a wide spectrum of ages, race/ethnicities, and geographic regions of the United States. This cross-cohort collaboration will provide a unique opportunity to conduct a comprehensive evaluation of sex and racial/ethnic health disparities in HF. Causal mediation analysis techniques will be used to estimate the degree to which single and multi-factor lifestyle and clinical interventions could potentially reduce health disparities in HF. In our phenomapping aim, we will define unique clinically relevant phenotypes of HF based upon cohort data that is also commonly present in medical records for enhanced generalizability, including age, race/ethnicity, sex, clinical signs, symptoms, biomarkers, ejection fraction, physiologic measures, and co-morbidities; we will also evaluate HF phenotype associations with CVD and all-cause mortality.