The Minnesota Heart Failure Consortium: A Regional Clinical Center

描述（由申请人提供）： 明尼苏达心力衰竭联盟（MHFC）由明尼苏达大学心脏病学系的教师领导，由在大双子城地区的10家诊所和医院执业的心脏病专家和护士组成。这些研究中心的患者人群包括所有严重程度的急性和慢性心力衰竭，以及广泛的人口统计学混合。MHFC成立于2002年，有一个全职的协调员，并建立了成功的合作调查和教育活动的记录。因此，领导层和基础设施已经到位，可以成为拟议网络中成功和富有成效的区域临床中心。RFA的研究提案首先包括一项新研究，其中将基于非利尿剂的容量控制策略的临床和生物学影响与急性心力衰竭失代偿患者的常规护理进行比较。研究将在住院期间启动，并持续3个月。超滤将用于实现和维持非利尿组的容量稳态。本研究的主要终点是维持稳定的肾功能。次要目标包括表征众多临床和生物学变量之间的关系以及出院后肾功能不全的发展。因此，本研究将解决利尿剂治疗对ADHF患者肾功能不全发生的急性和慢性影响的几个重要问题，代表了第一个不基于袢利尿剂的容量控制方案的长期试验，并显着扩展了关于ADHF患者临床过程中几个关键临床和生物学变量行为的知识基础。第二项拟议的研究涉及口服有效的选择性β-2肾上腺素能激动剂克仑特罗在中度至重度但稳定的慢性心力衰竭患者中的首次试验。这项研究将评估克伦特罗对这一人群中几个临床和生物学变量的影响，克伦特罗是一种基于终末期患者初步经验的有前途的药物。因此，这些建议处理及时的问题，代表了MHFC研究者和研究中心已经获得相当多经验的工作的逻辑扩展，有可能扩大我们对现有治疗策略作用的了解，或大幅增加关于有前途的新药物的信息。解决这些问题的协议将具有适当的规模，以研究拟议网络所设想的规模的协议。(End摘要）

DESCRIPTION (provided by applicant): The Minnesota Heart Failure Consortium (MHFC), led by faculty from the Division of Cardiology at the University of Minnesota, is comprised of cardiologists and nurses practicing at 10 clinics and hospitals in the greater Twin Cities area. Patient populations at these sites encompass both acute and chronic heart failure at all severity levels, and a wide demographic mix. The MHFC was formed in 2002, has a full time coordinator, and an established record of successful collaborative investigative and educational activity. Leadership and infrastructure are therefore in place to become a successful and productive Regional Clinical Center in the proposed network. Research proposals for the RFA include first a novel study in which the clinical and biological impact of a nondiuretic-based strategy of volume control will be compared with usual care in patients presenting with acute heart failure decompensation. The study will be initiated during hospital admission and continued for 3 months. Ultrafiltration will be used to achieve and maintain volume homeostasis in the nondiuretic group. The primary endpoint of this study is maintenance of stable renal function. Secondary goals include characterization of the relationship between numerous clinical and biological variables and the development of renal insufficiency in the post-discharge period. This study will therefore address several important questions regarding the acute and chronic impact of diuretic therapy on the development of renal dysfunction in patients with ADHF, represent the first chronic trial of a regimen for volume control not based on loop diuretics, and significantly expand the knowledge base regarding the behavior of several key clinical and biological variables on the clinical course of patients presenting with ADHF. The second proposed study involves the first test of the orally effective selective beta-2 adrenergic agonist clenbuterol in patients with moderate to severe, but stable chronic heart failure. The study will access the impact of clenbuterol, a promising agent based on preliminary experience in end-stage patients, on several clinical and biological variables in this population. These proposals therefore deal with timely questions, represent logical extensions of work with which MHFC investigators and sites have already obtained considerable experience, have the potential to either expand our knowledge of the role of existing treatment strategies or to substantially increase information regarding a promising new agent. Protocols to address these issues would be of suitable size for study in protocols of the size envisioned by the proposed network. (End of Abstract)