Midcareer Mentoring Award for Patient Oriented Research in Geriatric Cardiology

 描述（由申请人提供）：我的学术生涯表明了对以患者为导向的研究的长期承诺，在年龄相关的心血管疾病的病理生理学研究方面的广泛专业知识，这些疾病不成比例地折磨老年人，包括射血分数保留的心力衰竭，以及指导居民，心脏病学研究员和老年病和心脏病学初级教师的成功记录。我的职业规划是将我的研究兴趣扩展到与年龄相关的心血管疾病的多学科研究，重点是：（a）射血分数正常的心力衰竭，其占美国心力衰竭病例的一半以上，并且主要折磨老年人，（B）出现反常低流量主动脉瓣狭窄的表型和（c）几乎只影响老年人的TTR心脏淀粉样变性。在此奖项的任期内，申请人将加强现有的，并形成新的合作关系与基础和临床研究人员在哥伦比亚大学，并继续从老年医学，心脏病学和其他医学亚专业领域，将促进合作跨学科研究的年轻临床研究人员成功的指导计划。后者将通过大纽约老年心脏病联盟（www.gnygcc.org）的持续发展来实现，该联盟旨在通过进行创新的、研究者发起的、多中心协作临床研究来改善老年心血管疾病患者的护理。建议的指导计划包括四个其他组成部分：1）密集的个性化培训，以病人为导向的研究; 2）教学计划，临床试验设计数据分析，赠款写作，和道德; 3）一个小组/同伴指导CoMPAdRE计划（哥伦比亚导师同龄人老龄化研究计划）发展关系和4）由以患者为导向的研究专家团队进行严格审查，并提供360度全方位服务，鼓励学员成为“完美”的门徒，并协助他们建立PI评估网络 由学员和教员参与。在以患者为导向的研究中，这一职业中期研究者奖的更新将提供急需的保护时间，以实现这些职业目标，并继续指导哥伦比亚大学的五名现任K23获奖者以及外部机构和管道中的其他学员。哥伦比亚为申请人的职业发展提供了强大的制度环境。医学系和心脏病科已承诺保护申请人的时间为患者导向的研究和指导的50%。建议的目的是评价：（1）确定HF住院后DASH-SR饮食是否能诱导“享乐转变”并改变患者的盐敏感性。 老年人（2）评价TTR心脏淀粉样蛋白是否是因接受TAVR/SAVR的老年人中反常低流量主动脉瓣狭窄导致HFpEF表型的原因，（3）部署在线综合老年评估（CGA）工具并进行500次访谈，以推进CV疾病老年人的护理并改善QOL，（4）评价新措施的效用，心肌收缩分数（MCF）预测HFpEF。拟议的研究将促进申请人的职业发展，并提供一个机制，使学员能够获得必要的技能，以开始研究生涯，并收集数据，以支持补助金申请。最终目标是促进新一代心脏病学和老年医学研究人员的发展，他们可以在竞技场进行临床研究 老年心血管疾病

 DESCRIPTION (provided by applicant): My academic career demonstrates a long-term commitment to patient-oriented research, extensive expertise in the study of the pathophysiology of age related cardiovascular disorders that disproportionately afflict older adults including heart failure with preserved ejection fraction and a successful record in mentoring residents, cardiology fellows and junior faculty in geriatrics and cardiology. My career plan is to expand my research interests to multidisciplinary studies of age related cardiovascular conditions by focusing on: (a) heart failure with a normal ejection fraction, which accounts for more than half of the cases of heart failure in the United States and that afflicts predominately older adults, (b) the emerging phenotype of paradoxically low flow aortic stenosis and (c) TTR cardiac amyloidosis that almost exclusively affects older adults. During the tenure of this award, the applicant will strengthen existing and form new collaborative relationships with basic and clinical investigators at Columbia University and continue a successful mentoring program for young clinical investigators from geriatrics, cardiology and other subspecialty fields of medicine that will foster collaborative interdisciplinary investigations. The latter will be achieved by ongoing development of the Greater New York Geriatric Cardiology Consortium (www.gnygcc.org) aimed at improving the care of older adult patients with cardiovascular disease by performing innovative, investigator initiated, multicenter collaborative clinical investigation. The proposed mentoring program consists of four other components: 1) intensive individualized training in patient oriented research; 2) didactic programs on clinical trial design data analysis, grant writing, and ethics; 3) a group/peer mentoring CoMPAdRE Program (Columbia Mentor Peer Aging Research Program) developmental relationships and 4) critical review by a team of patient oriented research experts and a 360° that will seek to encourage mentees to be the "perfect" protégé and assist them in building a network of evaluation of the PI by mentees and faculty participants. Renewal of this Midcareer Investigator Award in Patient Oriented Research will provide critically needed protected time to achieve these career goals and continuing the mentorship of five current K23 awardees at Columbia University and other mentees at outside institutions and in the pipeline. Columbia provides a strong institutional environment for support of the applicant's career development. The Department of Medicine and Division of Cardiology have committed to protect 50% of the applicant's time for patient oriented research and mentoring. The proposed aims are to evaluate: (1) To determine if the DASH-SR diet post-hospitalization for HF can induce a "hedonic shift" and alter salt sensitivity in older adults (2) To evaluate whether TTR cardiac amyloid is the cause of the phenotype of HFpEF due to paradoxically low flow aortic stenosis in older adults undergoing TAVR/SAVR, (3) To deploy an online comprehensive geriatric assessment (CGA) instrument and conduct 500 interviews to advance care and improve QOL in older adults with CV disease, (4) To evaluate the utility of a novel measure, the myocardial contraction fraction (MCF) for predicting HFpEF. The proposed studies will advance applicant career development and provide a mechanism by which trainees can acquire the necessary skills to launch a research career and collect data to support grant applications. The ultimate goal is to facilitate the development of a new generation of investigators from both cardiology and geriatrics that can pursue clinical research in the arena of aging cardiovascular disease.