MENTORED PATIENT-ORIENTED RESEARCH CAREER DEVELOPMENT AWARD

描述（由申请人提供）：主要研究者将开发 在运动测试和儿童训练的专业知识，并获得 具备开展独立研究项目所需的经验和技能 在颁奖期间。 主要研究者的长期职业目标 作为一名学术儿科心脏病专家， 主要研究方向为运动生理学和心脏康复。 运动不耐受是一种未被充分认识的儿童慢性疾病， 心脏病 运动能力差导致自尊心低， 生活质量 儿童单心室Fontan手术后的临床分析 儿童原位心脏移植（OHT）后， 最低的运动能力。 是否在这些运动不耐受 儿童是由于心肺功能障碍或失调， 体力活动减少仍不清楚。 骨骼肌的作用， 体液反应对运动能力和运动效果的影响 心脏病儿童的训练情况尚不清楚。 他们提出了一种 前瞻性、随机和对照研究，比较体力活动 水平的健康儿童和儿童Fontan或OHT，以评估 与运动能力有关的骨骼肌、儿茶酚胺和细胞因子， 并确定运动训练对心肺功能的影响， 骨骼肌和生活质量。 为了进行这项研究， 6至13岁的青春期前儿童，包括40名 将招募Fontan、40名OHT后儿童和40名健康儿童。 受试者将随机接受为期6周的耐力训练计划，或 计算机讲习班（无培训）。 该项目将在五年内进行 年和培训班将在夏季举行。 以下测试 将在运动训练完成之前和之后立即进行： 通过双能X线骨密度仪（DEXA）扫描测量瘦体重，大腿肌肉 通过磁共振成像（MRI）、超声心动图、肺功能测定的容积 运动心肺功能试验，肿瘤坏死因子，儿茶酚胺 因子（TNF）-α、IL-1 β和IL-6水平， 通过活动监测器测量身体活动水平， 问卷 他们将比较儿童之间的这些测量结果， 训练组和未训练组的儿童运动效果比较 对Fontan、OHT患儿和健康儿童进行培训。 这项研究是 旨在确定儿童运动不耐受的重要机制 患有严重的心脏病 运动训练的结果将 提供与以下方面的生理和社会心理益处相关的证据： 增加身体活动，并为未来的研究奠定基础， 心脏病患儿的心肺康复。 校长 调查人员将参加高级课程，以提高所需的知识和技能 进行以病人为导向的研究，并与导师合作， 项目中标期间。

DESCRIPTION (provided by applicant): The principal investigator will develop expertise in exercise testing and training of children and obtain the experience and skill necessary to initiate independent research projects during the award period. The principal investigator's long-term career goal as an academic pediatric cardiologist is to become a clinical investigator with a research focus in exercise physiology and cardiac rehabilitation. Exercise intolerance is an under-recognized chronic morbidity in children with heart disease. Poor exercise capacity leads to low self-esteem and poor quality of life. Children with single ventricle after the Fontan operation and children after orthotopic heart transplantation (OHT) are among children with the lowest exercise capacity. Whether exercise intolerance in these children is due to cardiopulmonary dysfunction or deconditioning from decreased physical activity remains unclear. The role of skeletal muscle and humoral responses in determining exercise capacity and the effect of exercise training in children with heart disease are unknown. They propose a prospective, randomized and controlled study to compare physical activity level of healthy children and children with Fontan or OHT, to evaluate the skeletal muscle, catecholamine and cytokines in relation to exercise capacity, and to determine the effect of exercise training on cardiopulmonary function, skeletal muscle and quality of life. In order to conduct this study, prepubertal children six to 13 years of age, including 40 children after Fontan, 40 children after OHT, and 40 healthy children will be recruited. Subjects will be randomized to a six-week endurance training program or computer workshops (no training). The project will be conducted over five years and training sessions will be held in the summer. The following tests will be performed before and immediately after exercise training is completed: lean body mass by dual energy X-ray absorptiometry (DEXA) scan, thigh muscle volume by magnetic resonance imaging (MRI), echocardiogram, pulmonary function test, cardiopulmonary exercise test, catecholamine and cytokine tumor necrosis factor (TNF)-alpha, IL-1beta, and IL-6 levels at rest and during exercise, physical activity level by activity monitor and quality of life measures by a questionnaire. They will compare these measurements between children with training and children without training and compare the effect of exercise training on children with Fontan, OHT and healthy children. The study is designed to define important mechanisms of exercise intolerance among children with severe forms of heart disease. The results of exercise training will provide evidence related to the physiologic and psychosocial benefits of increased physical activity and form the basis for future research on cardiopulmonary rehabilitation for children with heart disease. The principal investigator will take advanced courses to enhance knowledge and skills needed for patient-oriented research and work with the mentors to conduct the proposed project during the award period.