Risk Factors for Atherosclerosis among Patients with Heart Failure in Kenya

描述（由申请人提供）：Gerald布卢姆菲尔德博士是杜克大学的心脏病学研究员。候选人的长期兴趣是成为发展中国家慢性心血管疾病（CVD）流行病学和治疗的临床研究人员，从而使用初级和二级预防方法改善弱势群体的健康。拟议的职业发展计划包括一个多学科的计划，旨在提供一个激烈的，密切指导，以病人为导向的研究经验，在生物统计学和流行病学的全面结构的教学课程。在John A. Bartlett博士（杜克全球健康研究所）、Bob哈灵顿博士（杜克临床研究所，DCRI）、Fabian Esamai博士（肯尼亚莫伊大学医学院）和托马斯Gaziano博士（哈佛大学公共卫生学院）、布卢姆菲尔德博士将在肯尼亚心力衰竭（HF）患者和非HF患者中采用病例对照研究设计。使用现代超声心动图，血清学检测和临床评估，我们的具体目标是确定和描述分类的心力衰竭在肯尼亚三级转诊大学诊所，特别强调缺血性心脏病，描述亚临床动脉粥样硬化的患病率在心力衰竭患者和描述的患病率可修改和不可修改的危险因素动脉粥样硬化在心力衰竭患者。通过与肯尼亚莫伊大学医学院合作一年来执行该项目，我们希望收集心力衰竭患者动脉粥样硬化负担的试点数据;从而为未来更大的前瞻性，区域相关分析提供假设。布卢姆菲尔德博士还将指导有抱负的肯尼亚临床研究人员，并促进部分临床研究培训计划。该候选人将拥有设在肯尼亚埃尔多雷特的美国/撒哈拉以南非洲培训和教育网络联合会的基础设施、病人人数和统计支助，该联合会的成员包括莫伊大学、印第安纳州大学、布朗大学和杜克大学。在第2年及以后，布卢姆菲尔德博士将参加DCRI临床研究培训计划，亲身体验进行国际临床试验的特点，参加每周的研究会议，在国家会议上发表摘要和起草手稿。 公共卫生相关性：随着撒哈拉以南非洲（SSA）的心血管疾病从传染性疾病转变为慢性退行性疾病，经济和人力成本将对该地区构成重大挑战。了解现代病因的HF和动脉粥样硬化的患病率在SSA是很重要的，这样我们就可以实施相关的预防策略，建立当地相关的长期登记，并适当地培训肯尼亚临床研究人员的干部，在未来的努力。

DESCRIPTION (provided by applicant): Dr. Gerald Bloomfield is a cardiology fellow-in-training at Duke University. The candidate's long-term interest is to become a clinical researcher in the epidemiology and treatment of chronic cardiovascular disease (CVD) in the developing world, thereby improving the health of the disadvantaged using primary and secondary prevention methods. The proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in biostatistics and epidemiology. Under the mentorship of Dr. John A. Bartlett (Duke Global Health Institute), Dr. Bob Harrington (Duke Clinical Research Institute, DCRI), Dr. Fabian Esamai (Moi University School of Medicine, Kenya) and Dr. Thomas Gaziano (Harvard University School of Public Health), Dr. Bloomfield will employ a case-control research design in Kenyan patients with and without heart failure (HF). Using modern echocardiography, serologic assays and clinical assessments, our specific aims are to identify and describe the taxonomies of heart failure in a Kenyan Tertiary Referral University clinic with special emphasis on ischemic heart disease, to describe the prevalence of subclinical atherosclerosis among patients with heart failure and to describe the prevalence of modifiable and non-modifiable risk factors for atherosclerosis among patients with heart failure. By spending one year with the Moi University School of Medicine in Kenya performing this project, we hope to collect pilot data on the burden of atherosclerosis among patients with heart failure; thereby informing hypotheses for larger prospective, regionally-relevant analyses in the future. Dr Bloomfield will also mentor aspiring Kenyan clinical researchers and facilitate portions of a clinical research training program. The candidate will have at his disposal the infrastructure, patient population and statistical support of the American/Sub Saharan African Network for Training and Education (ASANTE) consortium based in Eldoret, Kenya whose members include Moi University, Indiana University, Brown University and Duke University. In years 2 and beyond, Dr. Bloomfield will take part in the DCRI clinical research training program, experience first-hand the featutes of conducting international clinical trials, attend weekly research conferences, present abstracts at national.conferences and draft manuscripts. PUBLIC HEALTH RELEVANCE: As the landscape of CVD in Sub-Saharan Africa (SSA) shifts from communicable to chronic, degenerative diseases, the economic and human costs will significantly challenge the region. Understanding the modern etiologies of HF and prevalence of atherosclerosis in SSA are important so that we can implement relevant preventive strategies, create locally pertinent long-term registries and appropriately train a cadre of Kenyan clinician investigators to lead this effort in the future.