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Mass General Brigham HeartShare Clinical Center

麻省总医院布里格姆 HeartShare 临床中心

基本信息

批准号：
10679064
负责人：
Akshay Suvas Desai
金额：
$ 28.38万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-10 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10679064
关键词：
Academic Medical Centers Amyloid Amyloidosis Artificial Intelligence Bioinformatics Biological Markers Blood Vessels Blood gas Blood specimen Cardiac Cardiopulmonary Classification Clinical Clinical Pathways Clinical Research Clinical Treatment Clinical Trials Clinical assessments Cognition Collaborations Computerized Medical Record Coupled Data Development Diagnosis Dyspnea EFRAC Echocardiography Electronic Health Record Enrollment Epidemiology Evaluation Exercise Exercise Test Functional disorder Gases General Hospitals Geriatrics Heart failure Hospitals Human Subject Research Image Impairment Individual Institution Integrated Health Care Systems Intervention Trial Laboratories Leadership Lung Magnetic Resonance Imaging Massachusetts Measurement Mentors Morbidity - disease rate Multimodal Imaging Musculoskeletal National Heart, Lung, and Blood Institute Observational Study Operations Research Pathway interactions Patient Care Patient Recruitments Patients Pattern Peripheral Pharmacotherapy Phenotype Physiologic Monitoring Physiological Physiology Plasma Population Population Study Positron-Emission Tomography Principal Investigator Program Evaluation Proteomics Protocols documentation Research Research Infrastructure Research Personnel Rest Sampling Signal Transduction Site Structure Testing Therapeutic Intervention Translating Validation Woman adjudication arterial tonometry body system cardiovascular imaging clinical care clinical center clinical investigation cohort cost effective data quality design effective therapy experience frailty heart function heart imaging heart preservation hemodynamics improved insight medical specialties member metabolomics multidisciplinary multimodality novel novel therapeutic intervention observational cohort study participant enrollment patient population pharmacologic population based preservation pro-brain natriuretic peptide (1-76)programs public health relevance recruit screening transcriptomics unsupervised learning

项目摘要

Project Summary Heart failure with preserved ejection fraction (HFpEF) comprises approximately half of all HF and is a highly morbid condition. Pharmacotherapies that are effective in treating HF with reduced ejection fraction have more modest if any beneficial impacts on HFpEF, potentially owing to heterogeneous definitions of HFpEF and limited understanding of optimal pathways to target in HFpEF. Our team of investigators has extensive experience in HFpEF human subjects research. Complementary Dyspnea and Heart Failure Evaluation Programs attract referral of HFpEF patients as well as dyspneic control patients without HFpEF to the Massachusetts General Hospital and Brigham and Women’s Hospital (“Mass General Brigham, MGB”). In addition, our team is highly engaged in assessing therapeutic interventions for HFpEF through robust clinical trials programs. The MGB HeartShare Team’s PIs are responsible for HFpEF clinical trial conceptualization, design, implementation, and endpoint adjudication via established core laboratories in echocardiography, cardiopulmonary exercise testing, advanced cardiovascular imaging, all of which could be used to support HeartShare. Our team also has expertise in working with MGB-based electronic health record data, population study data, and clinical trials that inform our understanding of HFpEF. Our group has used comprehensive cardiopulmonary exercise testing (CPET) to simultaneously quantitate invasive hemodynamics, blood gases, cardiac function, arterial tonometry and gas exchange patterns during exercise in individuals with conventionally defined HFpEF. We have begun to delineate contributions of impaired cardiac, pulmonary, vascular, and peripheral musculoskeletal reserve capacity that are not evident at rest. Our single-center HFpEF phenotyping study already consists of >700 patients with HFpEF subjected to uniform phenotyping (echocardiography, NT-proBNP, multi-site blood sampling at rest and with exercise and comprehensive CPET). In Aim 1 we will assemble a collaborative multidisciplinary investigative team capable of recruiting, phenotyping, and retaining ≥250 HFpEF patients in the HeartShare Program while also drawing from experience with core lab oversight, bioinformatic expertise in electronic medical record research, and leadership of network, population cohort, and clinical trial research relevant to HFpEF. In Aim 2 we will refine the diagnosis and subclassification of HFpEF through comprehensive clinical assessment including multi-modality imaging of cardiac structure and function, perturbational testing with exercise to probe multi-organ system physiologic reserve and longitudinal remote physiologic monitoring and assessment of frailty and cognition. We will also expand on our experience with creation of omics-based signatures of pathophysiologic states in HFpEF and deploy unsupervised machine learning approaches to the derived data. HeartShare will enhance understanding of HFpEF and our team is poised to translate improved understanding of HFpEF subtypes into new therapeutic intervention trials in HFpEF.

项目总结