The Relationship of Exercise Associated Cardiac Reserve on Peak Oxygen Consumption and Frailty Measures in Individuals Undergoing Allogeneic Hematopoietic Stem Cell Transplant.

运动相关心脏储备与接受同种异体造血干细胞移植的个体的峰值耗氧量和虚弱测量的关系。

• 批准号: 10591734
• 负责人: Justin McNair Canada
• 金额: $ 14.9万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10591734
• 关键词: Acute Myelocytic Leukemia; Address; Allogenic; Assessment tool; Biomedical Engineering; Body Weight decreased; Canada; Cancer Center; Cardiac; Cardiac Output; Cardiopulmonary; Cardiovascular Diseases; Cardiovascular system; Clinical; Clinical Management; Clinical Oncology; Clinical Trials; Collection; Communities; Coupled; Data; Development Plans; Disease; Doctor of Philosophy; Early Diagnosis; Elderly; Eligibility Determination; Environment; Equation; Equipment; Evaluation; Exclusion; Exercise; Exercise Tolerance; Exposure to; Feasibility Studies; Future; Gait speed; Gases; Goals; Health; Heart failure; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Imaging Techniques; Impairment; Individual; International; Intravenous; Ionizing radiation; Life; Magnetic Resonance; Magnetic Resonance Imaging; Malignant Neoplasms; Measurement; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Methods; Morbidity - disease rate; Muscle; Myocardial dysfunction; Oncologist; Oncology; Outcome; Oxygen; Oxygen Consumption; Patients; Peripheral; Phenotype; Physical Performance; Physical activity; Physicians; Play; Principal Investigator; Procedures; Publications; Qualifying; Quality of life; Relapse; Reproducibility; Research; Research Personnel; Research Training; Risk; Role; Scientist; Serious Adverse Event; Stress; Survivors; Syndrome; Techniques; Testing; Therapeutic Intervention; Time; Training; Transplant Recipients; Transplantation; Treatment-Related Cancer; Virginia; adverse event risk; cancer therapy; cardiac magnetic resonance imaging; career development; cofactor; comorbidity; curative treatments; design; disability; exercise capacity; exercise intolerance; exercise physiologist; exhaustion; frailty; functional status; heart function; heart imaging; hematopoietic cell transplantation; improved; improved outcome; innovation; interest; leukemia; leukemia treatment; mortality; mortality risk; multidisciplinary; novel; older patient; patient oriented; programs; responsible research conduct; side effect; success; supportive environment; targeted treatment; temporal measurement; theories; translational scientist; transplantation therapy

PROJECT SUMMARY This K23 project will prepare the Principal Investigator, Justin M. Canada, PhD, to develop as an independent clinical/translational researcher who is expert in a novel form of cardiopulmonary exercise stress measurement – cardiovascular magnetic resonance imaging (MRI) – to identify factors that reduce peak oxygen consumption (VO2) in patients with heart failure. Peak VO2 reflects peak exercise capacity, a prime determinant of outcomes among patients with cardiovascular disease (CVD). This noninvasive methodology does not require intravenous contrast or ionizing radiation, eliminating possible side effects among patients in poor health. It also accurately measures exercise-associated cardiac output—a fundamental contributor to overall exercise capacity—that can be targeted with therapeutic interventions to improve overall peak exercise capacity. This project is a collaborative multi-disciplinary effort among oncologists, exercise physiologists, biomedical engineers, and cardiovascular experts to address an important issue in the emerging field of cardio-oncology. The proposal focuses on patients receiving allogeneic hematopoietic stem cell transplantation (HCT) for hematologic malignancies. Treatment-associated reductions in peak VO2 can exclude candidates from life- saving HCT. Among survivors of hematologic malignancies, reduced peak VO2 is associated with impaired quality of life and elevated risk of death not related to relapse. At present, there is no reliable method to identify those at risk for these serious adverse events. In addition to a strong, supportive environment that includes international experts, the largest HCT program in Virginia, and state-of-the-art equipment co-located within the Cancer Center that serves the HCT community, the proposal is buttressed by highly supportive preliminary data and a robust career development plan for Dr. Canada. This plan provides mentored training in the translational fundamentals of MRI theory: conduct, interpretation, and MRI application in cardiovascular and cardio-oncology clinical management. This includes expertise in the technical aspects, analysis, interpretation, and utilization of an innovative exercise stress-associated cardiovascular MRI technique to discern the mechanism of reduced exercise capacity in other heart failure syndromes. This patient-oriented mentored research training plan incorporates a highly innovative technique and an excellent training environment to develop and test a methodology that identifies the causes of reductions in peak exercise capacity, a primary determinant of HCT outcomes. The outstanding mentor team will guide the Candidate’s progress in professional milestones (publications and presentations) and oversee his continued exposure to responsible conduct of research training. At completion of this K23, Dr. Canada will be well- qualified to contribute meaningfully to an emerging field of growing research interest.

项目摘要 这个K23项目将准备主要研究者，贾斯汀M。加拿大，博士，发展成为一个 独立临床/转化研究人员，擅长新型心肺运动应激 测量-心血管磁共振成像（MRI）-以确定降低峰值的因素 心力衰竭患者的氧耗量（VO 2）。峰值VO 2反映了峰值运动能力， 心血管疾病（CVD）患者预后的决定因素。这种非侵入性的方法 不需要静脉注射造影剂或电离辐射，消除了患者可能的副作用， 健康状况不佳。它还能准确测量运动相关的心输出量，这是 整体运动能力-可以通过治疗干预来改善整体峰值运动 容量 该项目是肿瘤学家、运动生理学家、生物医学专家、 工程师和心血管专家，以解决新兴的心脏肿瘤学领域的一个重要问题。 该提案的重点是接受异基因造血干细胞移植（HCT）的患者， 血液恶性肿瘤与治疗相关的峰值VO 2降低可能会使候选人退出生命- 拯救HCT在恶性血液病的幸存者中，峰值VO 2降低与受损的 生活质量和死亡风险升高与复发无关。目前还没有可靠的方法来鉴定 这些严重不良事件的风险。 除了包括国际专家在内的强大的支持性环境外， 在弗吉尼亚州，最先进的设备共同位于癌症中心，为HCT服务 社区，该提案得到了高度支持的初步数据和强大的职业发展的支持 加拿大博士的计划该计划提供MRI理论转化基础方面的指导培训： 心血管和心脏肿瘤临床管理中的行为、解释和MRI应用。这 包括创新实践的技术方面、分析、解释和利用方面的专业知识 应激相关的心血管MRI技术，以辨别运动能力降低的机制， 其他心力衰竭综合征。 这种以患者为导向的指导研究培训计划结合了高度创新的技术和 良好的培训环境，以制定和测试一种方法，确定减少的原因， 峰值运动能力，HCT结果的主要决定因素。优秀的导师团队将指导 候选人在专业里程碑（出版物和演示文稿）方面的进展，并监督他继续 接受负责任的研究培训。在K23完成后，加拿大博士将很好- 有资格为日益增长的研究兴趣的新兴领域做出有意义的贡献。