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Pulmonary Vascular Disease as a Contributor to Respiratory Morbidity in Chronic Obstructive Pulmonary Disease

肺血管疾病是慢性阻塞性肺疾病呼吸系统疾病发病的一个原因

基本信息

批准号：
10449417
负责人：
Aparna Balasubramanian
金额：
$ 19.82万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-01 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10449417
关键词：
Address Adult Affect Alveolar capillary destruction Alveolus American Award Biometry Blood flow Cardiac Catheterization Procedures Cardiology Caring Chronic Obstructive Pulmonary Disease Clinical Clinical Trials Cohort Studies Development Diagnostic tests Diffuse Disease Disease Management Echocardiography Environment Epidemiology Evaluation Foundations Funding Future Gases Gold Guidelines Impairment Individual International Intervention Knowledge Longitudinal Studies Longitudinal cohort Lung Lung Capacity Magnetic Resonance Imaging Measurement Measures Mentorship Methodology Modality Morbidity - disease rate Multicenter Studies Outcome Participant Patients Physiological Population Procedures Prospective cohort Pulmonary Hypertension Pulmonary Vascular Resistance Radiology Specialty Recommendation Recording of previous events Research Research Design Research Personnel Research Priority Resources Right ventricular strain Severities Severity of illness Site Specificity Symptoms Techniques Testing Therapeutic Therapeutic Trials Time Training United States United States National Institutes of Health Validation Vascular remodeling cardiac magnetic resonance imaging career development clinically relevant cohort comorbidity diagnosis standard diagnostic accuracy functional status health related quality of life hemodynamics improved outcome insight mortality multidisciplinary multimodality novel novel marker prevent prognostic prospective pulmonary arterial pressure pulmonary vascular disorder respiratory morbidity right ventricular failure skills study population vascular bed

项目摘要

Project Summary/Abstract Chronic obstructive pulmonary disease (COPD) occurs in over 15 million adults in the US. As many as 35% of those patients develop pulmonary vascular disease (PVD), but the recommendations for assessment and management of PVD in COPD have been limited by key knowledge gaps. Firstly, assessment of the pulmonary vasculature has relied upon invasive right heart catheterization as the gold standard, limiting studies to select populations with severe PVD. Noninvasive techniques, though widely available, have also been primarily validated in populations with severe PVD applying markers that are likely to reflect end-stage PVD, such as right ventricular failure. As a result, another key knowledge gap is the unknown contribution of PVD to COPD morbidity across its observed spectrum of severity. While the concomitant presence of severe PVD is observed to portend increased morbidity and mortality compared to those with COPD alone, the contribution of less severe PVD, at potentially more intervenable points in the disease course is less well-understood. This proposal seeks to address these knowledge gaps in three aims by (SA1) testing the diagnostic accuracy of three noninvasive markers that are selected for plausible sensitivity to early PVD, (SA2) and applying these noninvasive markers to understand the contribution of PVD to respiratory morbidity in cross-sectional and (SA3) longitudinal study designs. This application will add noninvasive markers to a general COPD cohort unselected for PVD and will further assemble a prospective longitudinal cohort of COPD patients enriched for PVD with the same noninvasive testing. The results of this proposal will identify novel noninvasive approaches for assessing PVD, define their clinical relevance across the spectrum of PVD, and establish opportunities to study the use of noninvasive markers as candidate outcomes in clinical trials targeting the pulmonary vasculature to manage COPD. Dr. Balasubramanian’s proposal is a strong training vehicle for her career development, offering her skills in hands-on cohort study design and execution, advanced biostatistical and epidemiologic methodology, and noninvasive and invasive assessment of PVD in COPD through numerous modalities including right heart catheterization, magnetic resonance imaging, speckle-tracking echocardiography, and physiologic measurements of diffusing capacity of the lung. Dr. Balasubramanian will be supported by a strong multi- disciplinary mentorship team with expertise in COPD, pulmonary hypertension, cardiology, radiology, and biostatistics. She further will leverage an exceptional institutional environment with its collaborative and supportive culture, extensive intellectual and physical resources, and strong history of supporting junior investigators. This award will establish Dr. Balasubramanian as an independent investigator with a unique research niche, distinct from her mentorship team, and establish a foundation for future studies evaluating and managing PVD in COPD.

项目总结/文摘