Ventricular and Pulmonary Vascular Reserve after the Fontan Operation

Fontan 手术后心室和肺血管储备

• 批准号: 10133126
• 负责人: Alexander Egbe
• 金额: $ 17.33万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10133126
• 关键词: Address; Adult; Arrhythmia; Award; Blood; Blood Circulation; Blood Vessels; Blood flow; Bypass; Cardiac Catheterization Procedures; Cardiopulmonary; Cardiovascular Physiology; Caring; Catheterization; Central venous pressure; Chronic; Chronic Kidney Failure; Cirrhosis; Clinic; Clinical; Clinical Investigator; Common Ventricle; Complex; Congestive; Data; Deterioration; Diagnostic; Disease; Disease Progression; Early identification; Echocardiography; Exercise; Exercise Physiology; Exercise Test; Exposure to; Failure; Fontan Procedure; Functional disorder; Goals; Gold; Grant; Health Care Costs; Healthcare; Heart failure; Hemodynamic Processes; Hypertension; Intervention; Knowledge; Lead; Life Expectancy; Literature; Low Cardiac Output; Lung; Mentors; Mentorship; Methodology; Methods; Morbidity - disease rate; Natural History; North America; Organ; Outcome; Outcome Measure; Patient Care; Patient Outcomes Assessments; Patient Recruitments; Patients; Physiology; Population; Prevalence; Prevention strategy; Protein-Losing Enteropathies; Public Health; Pulmonary Circulation; Research; Research Design; Research Personnel; Resources; Rest; Risk Management; Role; Side; Stress; Supination; Thromboembolism; Time; Vascular Diseases; Venous; Ventricular; Work; career; cohort; comorbidity; congenital heart disorder; electric impedance; experience; follow-up; hemodynamics; improved; innovation; mortality; novel; operation; palliation; pressure; prevent; programs; response; risk stratification; skills; symptom management; tool; treatment strategy

PROJECT SUMMARY CANDIDATE: Dr. Egbe's long-term goal is to become an independent clinical investigator in the field of adult congenital heart disease. His short-term goal is to study new and unexplored aspects of hemodynamics and clinical outcomes in people with Fontan palliation. To achieve these goals, Dr. Egbe plans to: (1) Acquire expertise in advanced statistical methodology, exercise physiology and hemodynamics, and management of circulatory failure in people with Fontan physiology; (2) Develop new collaborative relationships with other researchers; (3) Submit RO1 proposals during the 3rd and 5th years of the award. ENVIRONMENT: The Mayo Clinic is a world-renowned center for innovation and research, and the Adult Congenital Heart Disease program at Mayo Clinic cares for the largest cohort of Fontan patients in North America, making it ideal for patient recruitment for the proposed studies. Dr. Borlaug, the primary mentor for this grant, is an expert in exercise hemodynamics and cardiovascular physiology, and has a track record of successful mentorship. RESEARCH Background: Patients with Fontan palliation have significantly reduced long-term survival because of Fontan associated diseases (FAD). Available data suggest that FAD are downstream complications of chronic venous congestion, but there is paucity of data about the upstream hemodynamic processes, such as pulmonary vascular disease (PVD) and ventricular diastolic dysfunction (VDD), responsible for chronic venous congestion and FAD. We will address these gaps in knowledge through the proposed studies. Specific Aims: We will determine the prevalence of PVD and VDD in patients with Fontan physiology using invasive and noninvasive hemodynamic cardiopulmonary exercise testing (Aims #1 and #2), and then evaluate the impact of rest-exercise PVD and VDD on clinical outcomes (Aim #3). Study Design and Outcome Measures: The studies will be conducted on adult Fontan patients undergoing cardiac catheterization for clinical indications at Mayo Clinic Rochester, MN. Simultaneous cardiac catheterization and echocardiography will be performed at rest and during exercise (Aims #1 and #2), and the occurrence of rest-exercise PVD and VDD will be correlated with clinical outcomes during follow-up (Aim#3). Potential Public Health Contribution: Identifying and treating the early stages of PVD and VDD will potentially prevent or at least deter FAD, improve survival and reduce healthcare cost in this population. Relationship to the Career Goals of the Candidate: The data and skill set acquired during these projects will form the basis for an RO1 application focused on modifying the natural history of FAD, a critical step towards becoming an independent clinical investigator in this field.

项目总结

项目成果

Outcomes of Anticoagulation Therapy in Adults With Tetralogy of Fallot.

法洛四联症成人抗凝治疗的结果。

• DOI: 10.1161/jaha.118.011474
• 发表时间: 2019
• 期刊: Journal of the American Heart Association
• 影响因子: 5.4
• 作者: Egbe,AlexanderC;Miranda,WilliamR;Ammash,NaserM;Missula,VenkataR;Jadav,Raja;Najam,Maria;Kothapalli,Srikanth;Connolly,HeidiM
• 通讯作者: Connolly,HeidiM

Impact of Inferior Venae Cava Assessment in Tetralogy of Fallot.

下腔静脉评估对法洛四联症的影响。

• DOI: 10.1016/j.cjco.2020.02.006
• 发表时间: 2020
• 期刊: CJC open
• 作者: Egbe,AlexanderC;Vojjini,Rahul;Pellikka,PatriciaA;Bonnichsen,Crystal;Anderson,JasonH;Taggart,NathanielW
• 通讯作者: Taggart,NathanielW

Cardiac implantable electronic devices in adults with tetralogy of Fallot.

• DOI: 10.1136/heartjnl-2018-314072
• 发表时间: 2019-04
• 期刊: Heart (British Cardiac Society)
• 作者: Egbe AC;Miranda WR;Madhavan M;Ammash NM;Missula VR;Al-Otaibi M;Fatola A;Kothapalli S;Connolly HM
• 通讯作者: Connolly HM

Cardiac Remodeling and Disease Progression in Patients With Repaired Coarctation of Aorta and Aortic Stenosis.

• DOI: 10.1161/circimaging.121.013383
• 发表时间: 2021-12
• 期刊: Circulation. Cardiovascular imaging
• 作者: Egbe AC;Oh JK;Pellikka PA
• 通讯作者: Pellikka PA

Coarctation of aorta is associated with left ventricular stiffness, left atrial dysfunction and pulmonary hypertension.

• DOI: 10.1016/j.ahj.2021.07.005
• 发表时间: 2021-11
• 期刊: American heart journal
• 影响因子: 4.8
• 作者: Egbe AC;Miranda WR;Connolly HM;Borlaug BA
• 通讯作者: Borlaug BA