The kidney in advanced heart failure and durable mechanical circulatory support: phenotypes, prediction, and pathophysiology

晚期心力衰竭中的肾脏和持久机械循环支持：表型、预测和病理生理学

基本信息

批准号：
10627799
负责人：
Carl Walther
金额：
$ 18.44万
依托单位：
BAYLOR COLLEGE OF MEDICINE
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：
2020-09-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10627799
关键词：
Acute Affect Anatomy Animal Model Animals Area Bayesian Analysis Biological Biological Markers Board Certification Cardiac Output Cardiac Surgery procedures Cardiorenal syndrome Central venous pressure Cessation of life Characteristics Chronic Clinical Clinical Data Clinical Investigator Clinical Research Cluster Analysis Coca Complex Congestive Heart Failure Creatinine Databases Dialysis procedure Dimensions Disease Doctor of Philosophy Environment Event Factor Analysis Fibrosis Filtration Foundations Functional disorder Goals Health Heart Heart Diseases Heart Transplantation Heart failure Hour Individual Inflammation Injury Ischemia Kidney Kidney Diseases Kidney Transplantation Knowledge Length Master of Science Measurement Measures Medical center Medicine Mentors Modernization Multicenter Trials Nephrology Niacinamide Non-Insulin-Dependent Diabetes Mellitus Oral Outcome Patients Perioperative Persons Phenotype Physiology Population Process Quality of life Refractory Renal function Research Research Methodology Research Support Research Technics Risk Risk Assessment Science Sepsis Serum Severities Techniques Texas Time Training Training Programs Tubular formation Uncertainty Variant advanced analytics analytical method biomarker panel blood pressure control cardiovascular health career cohort college experience heart function high risk implantation improved inflammatory marker innovation insight interstitial kidney dysfunction kidney imaging left ventricular assist device mechanical circulatory support medical specialties multidimensional data novel precision medicine predictive modeling professor prospective randomized trial renal damage repaired symposium systemic inflammatory response

项目摘要

PROJECT SUMMARY/ABSTRACT: This proposal outlines a 5-year mentored training program to develop Carl Walther, MD, MS, Assistant Professor of Medicine-Nephrology at Baylor College of Medicine, into an independent clinical investigator. Dr. Walther is a board-certified nephrologist with a Master of Science in Clinical Research. His research focuses on the nexus of kidney disease and heart disease, in particular the high burden of kidney disease in the rapidly growing field of durable mechanical circulatory support (primarily left ventricular assist devices [LVADs]) for advanced heart failure (HF). This proposal contains an integrated training and research plan to build Dr. Walther’s strong foundation of knowledge and experience into expertise in innovative research methods and practice to improve kidney disease in LVAD recipients and others with advanced heart failure. The career goals are: 1) train in the advanced/modern analytic and statistical techniques necessary to obtain valid, useful, individualized information from dense, multidimensional data; 2) develop expertise in physiology and prospective research techniques, including translational biomarker science, necessary for individualized characterization of kidney and cardiovascular health; 3) experience leading a prospective, multispecialty, collaborative study in a multimorbid population. The integrated, collaborative training and research plan includes formal coursework, mentored activities, conferences and targeted short courses, and will be performed in the outstanding environment of Baylor and the Texas Medical Center. He will be guided by a team of senior mentors and consultants with broad expertise: advanced analytic methods (Wolfgang Winkelmayer, MD, MPH, DSc and Jesse Schold, PhD), translational biomarker science (Steven Coca, DO, MS), prospective kidney research (Sankar Navaneethan MD, MPH, MS), prospective mechanical circulatory support research (Kenneth Liao, MD, PhD), and functional kidney imaging (Emily Chang, MD). The specific aims unify to precisely understand and predict adverse kidney outcomes with durable mechanical circulatory support. Aim 1 will identify novel global phenotypes in advanced heart failure at high risk for important adverse kidney outcomes, leveraging an existing national database. Aim 2 will prospectively assess how kidney parenchymal health prior to LVAD implantation (measured non-invasively, using a panel of kidney biomarkers) is related to important kidney outcomes. Aim 3 will study how kidney parenchymal health changes during long-term mechanical circulatory support, and the relationship of longitudinal kidney parenchymal health with neurohormonal activation and inflammation. This research is innovative in its precise approach to understanding and predicting the effects of durable mechanical circulatory support on global kidney health, an essential step towards reducing the growing burden of cardiorenal disease.

项目摘要/摘要：该提案概述了一项为期5年的修订培训计划，以开发医学博士Carl Walther，MS，Baylor医学院医学副教授助理教授独立临床研究者。沃尔瑟（Walther）博士是一名经过董事会认证的肾脏科学家临床研究。他的研究重点是肾脏疾病和心脏病的联系，特别是在耐用的机械电路支撑的快速增长领域，肾脏疾病的高负担（主要是用于晚期心力衰竭（HF）的左心室辅助设备[LVADS]）。该建议包含一个集成的培训和研究计划，将沃尔瑟博士建立强大的知识和经验基础为专业知识在创新的研究方法和实践中，以改善LVAD接受者的肾脏疾病以及其他先进的心力衰竭。职业目标是：1）训练高级/现代分析和统计从密集的多维数据中获得有效，有用的个性化信息所需的技术； 2）开发生理学和前瞻性研究技术方面的专业知识，包括转化生物标志物科学，对于肾脏和心血管健康的个性化表征所必需的； 3）经验领导一项对多次虫种群的前瞻性，多专业，合作研究。综合的，协作培训和研究计划包括正式课程，修改活动，会议以及有针对性的短课程，将在贝勒和德克萨斯医学的杰出环境中进行中心。他将由拥有广泛专业知识的高级导师和顾问团队的指导：高级分析方法（Wolfgang Winkelmayer，医学博士，MPH，DSC和Jesse Scold，PhD），翻译生物标志物科学（Steven Coca，Do，MS），前瞻性肾脏研究（Sankar Navaneethan MD，MPH，MS），前瞻性机械电路支持研究（医学博士Kenneth Liao，博士）和功能性肾脏成像（Emily Chang，医学博士）。具体的目的是统一以精确理解和预测广告肾脏的结果耐用的机械电路支撑。 AIM 1将在晚期心力衰竭中确定新颖的全球表型重要的不良肾脏结果的高风险，利用现有的国家数据库。 AIM 2意志前瞻性评估LVAD植入之前肾脏实质健康的方式（非侵入性测量，使用一组肾脏生物标志物）与重要的肾脏结局有关。 AIM 3将研究肾脏如何长期机械电路支持期间实质性健康变化，以及纵向肾实质健康，具有神经激活和注射。这项研究是创新的方法是理解和预测耐用机械电路的影响的精确方法支持全球肾脏健康，这是减少心脏疾病燃烧日益增长的重要一步。