The Relationship of Obesity with Subclinical Myocardial Injury and Heart Failure

描述(由申请人提供)：Chiadi E.Nduele，医学博士，医学硕士，约翰霍普金斯大学心脏病学系助理教授。恩杜梅勒博士寻求获得以患者为导向的研究职业发展奖，以获得技能、知识和研究经验，为成为心血管疾病预防领域的独立研究员奠定基础。恩杜梅尔博士的职业发展计划包括完成约翰霍普金斯大学彭博公共卫生学院的流行病学博士学位、约瑟夫·科雷什博士、医学博士和加里·格斯滕布利斯博士的指导，以及研究肥胖与亚临床心肌损伤、心肌功能障碍和突发心力衰竭之间的关系的临床研究。研究议程的具体目的是：1)评估成人体重史与心肌损伤、心肌功能障碍和心力衰竭的发展之间的关系；2)通过心脏磁共振波谱评估心肌脂肪变性与心肌损伤和功能障碍的关系；3)测试减肥手术前后故意减肥对心肌损伤和功能障碍的纵向影响，并在新的病态肥胖成年人队列中识别心肌损伤的新危险因素。获奖期间的目标包括发展临床研究的设计、性能、分析和展示方面的专业知识，包括通过指导性研究和定制的教学课程在新的队列中领导数据收集。长期目标包括发展作为独立临床调查员的职业，以及开发预防与肥胖相关的心血管疾病的新方法。肥胖与心肌功能障碍和心力衰竭的发展密切相关，但这种关系背后的机制鲜为人知，传统的危险因素只能部分解释这种关系。最近的研究表明，肥胖和心肌损伤之间存在独立的、分级的关系，以一种新的肌钙蛋白T(hs-cTnT)高灵敏度测定为指标，在没有临床心血管疾病的个体中，这种疾病预示着发生心力衰竭的风险显著增加。这项拟议的研究旨在阐明肥胖与亚临床心肌损伤、心肌功能障碍和心力衰竭之间的关系，以及 为肥胖个体的心血管风险预测和预防提供未来战略的目标。

DESCRIPTION (provided by applicant): Chiadi E. Ndumele, MD, MHS is an Assistant Professor in the Division of Cardiology at Johns Hopkins University. Dr. Ndumele seeks a Mentored Patient-Oriented Research Career Development Award in order to obtain the skills, knowledge and research experience to provide the foundation for a career as an independent investigator in the field of cardiovascular disease prevention. Dr. Ndumele's career development plan includes the completion of a doctorate in Epidemiology at the Johns Hopkins Bloomberg School of Public Health, mentorship from Dr. Josef Coresh, MD, PhD and Dr. Gary Gerstenblith, M.D., and clinical research examining the relationship of obesity with subclinical myocardial injury, myocardial dysfunction and incident heart failure. The specific aims of the research agenda are to: 1) Evaluate the relationship of adult body weight history with the development of myocardial injury, myocardial dysfunction and incident heart failure; 2) Characterize the relationship of myocardial steatosis, evaluated by cardiac MRI spectroscopy, with myocardial injury and dysfunction; 3) To test the longitudinal effects of intentional weight loss before and after bariatric surgery on myocardial injury and dysfunction, and to identify novel risk factors fo myocardial injury in a new cohort of morbidly obese adults. The goals during the award period include developing expertise in the design, performance, analysis and presentation of clinical research, including leading data collection in a new cohort, through mentored research and tailored didactic coursework. Long term goals include developing a career as an independent clinical investigator and developing new approaches for preventing cardiovascular disease related to obesity. Obesity is strongly associated with the development of myocardial dysfunction and heart failure, but the mechanisms underlying this relationship are poorly understood and only partially explained by traditional risk factors. Recent studies demonstrate an independent, graded relationship between obesity and myocardial injury, as indexed by a novel high sensitivity assay for troponin T (hs-cTnT), among individuals without clinical cardiovascular disease that portends a markedly increased risk for the development of heart failure. The proposed research aims to elucidate the factors mediating the relationship of obesity with subclinical myocardial injury, myocardial dysfunction and incident heart failure, with the goal of informing future strategies for cardiovascular risk prediction and prevention among individuals with obesity.