Effectiveness of Indoor Air Purifiers on Heart Failure Outcomes (The PURI-HF Trial)

室内空气净化器对心力衰竭结果的有效性（PURI-HF 试验）

• 批准号: 10494126
• 负责人: NITISH NAIK
• 金额: $ 33.9万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-25 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10494126
• 关键词: Activities of Daily Living; Acute; Adverse effects; Air; Air Pollution; Arrhythmia; Blood Pressure; Caliber; Cancer Control; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic; Cities; Clinical; Cost Effectiveness Analysis; Country; Diabetes Mellitus; Disease; Disease Outcome; EFRAC; Effectiveness; Environmental Health; Environmental Impact; Environmental Risk Factor; Exposure to; Health; Heart failure; Hospitalization; Household; Human; Incidence; India; Indoor Air Pollution; Institutes; Intervention; Knowledge; Link; Long-Term Effects; Mediating; Mediation; Mediator of activation protein; Medical; Morbidity - disease rate; Outcome; Participant; Particulate Matter; Patients; Pollution; Prevention program; Principal Investigator; Quality of life; Randomized Controlled Trials; Recommendation; Research; Research Personnel; Research Training; Risk Factors; Science; Site; Statistical Data Interpretation; Stroke; Techniques; Test Result; Testing; Walking; air filter; ambient air pollution; cardiovascular health; cooking; effectiveness evaluation; experience; fine particles; high efficiency particulate air filter; human subject; improved; indoor air; innovation; low and middle-income countries; medical schools; mortality; portability; process evaluation; programs; therapy design; training opportunity; ventilation

Project Abstract: Effectiveness of Indoor Air Purifiers on Heart Failure Outcomes (PURI-HF Trial) Indoor air pollution is one of the leading risk factors for global mortality, with over 90% of pollution-related deaths occurring in low- and middle- income countries (LMICs). Fine mode particulate matter with an aerodynamic diameter smaller than 2.5 micrometers (PM2.5) is a major contributor to global morbidity and mortality, particularly due to cardiovascular disease (CVD). There is a strong link between both acute and chronic PM2.5 air pollution exposure and heart failure (HF) incidence, hospitalizations, and mortality. Most recommendations to reduce air pollution-mediated CVD have focused on improved cooking techniques and ventilation, but with mixed results. New strategies to improve air quality and cardiovascular health are needed. For the past few decades, high-efficiency particulate air (HEPA) purifiers have been studied in LMICs to decrease PM2.5 pollution and improve health outcomes. However, there remain substantial gaps in understanding the long-term effects of air purifiers on functional and clinical HF outcomes. We are an established group of investigators with a successful track record of innovative and impactful studies at the intersection of air pollution and CVD. We will leverage our experience to study the impact of an innovative approach to reduce the adverse impact of air pollution and improve HF outcomes in India. The PURI-HF Trial aims to demonstrate the efficacy, feasibility and effectiveness of portable air filters in improving indoor PM2.5 levels and improving functional capacity of HF patients with reduced ejection fraction (HFrEF) in India. Our proposed partnership between NYU Grossman School of Medicine and All India Institute of Medical Sciences will emphasize capacity building and cross-institutional training opportunities throughout the duration of the project. Aim 1 will be a randomized controlled trial to evaluate the effectiveness of indoor air purifiers on HF functional capacity (6-minute walk test) among patients with HReEF in Delhi, Ludhiana, and Thiruvananthapuram. We will also conduct a moderation analysis to evaluate whether level of ambient air pollution, as well as spatial/environmental factors, moderate the impact of air purifiers on HF outcomes. Aim 2 will involve a causal mediation analysis to determine if the reduction in PM2.5 is associated with the relationship between air purifiers and HF outcomes. We will also assess whether seasonality correlates with the reduction in indoor PM2.5 concentrations in participant households, and we will determine the impact of air purifier use on the composition of PM2.5 air pollution in the three study sites. Aim 3 will be comprised of a cost-effectiveness analysis and process evaluation of the intervention. The research will be conducted by a transdisciplinary research team with diverse and complementary expertise led by two experienced Principal Investigators. We intend to add to existing knowledge of innovative and scalable strategies to improve environmental and cardiovascular health worldwide.

项目摘要：室内空气净化器对心力衰竭结果的有效性（Puri-HF试验） 室内空气污染是全球死亡率的主要风险因素之一，超过90％与污染有关 在低收入国家（LMIC）中发生死亡。精细的模式颗粒物与 空气动力学直径小于2.5微米（PM2.5）是全球发病率和 死亡率，特别是由于心血管疾病（CVD）。急性和 慢性PM2.5空气污染暴露和心力衰竭（HF）发病率，住院和死亡率。最多 减少空气污染介导的CVD的建议集中于改进的烹饪技术 和通风，但结果好坏参半。改善空气质量和心血管健康的新策略是 需要。在过去的几十年中，已经研究了高效颗粒空气（HEPA）净化器 LMIC可减少PM2.5污染并改善健康结果。但是，仍然存在很大的空白 在理解空气净化器对功能和临床HF结果的长期影响。我们是一个 建立的研究人员群体在创新和有影响力的研究中成功记录 空气污染与CVD的交集。我们将利用我们的经验来研究创新的影响 减少空气污染的不利影响并改善印度HF结果的方法。 puri-hf 试验旨在证明便携式空气过滤器改进的功效，可行性和有效性 室内PM2.5水平和提高射血分数降低（HFREF）患者的功能能力 在印度。我们在纽约大学格罗斯曼医学院与全印度研究所之间的拟议合作伙伴关系 医学科学将强调能力建设和跨机构培训机会 项目的持续时间。 AIM 1将是一项随机对照试验，以评估 在德里，Hreef患者的HF功能能力（6分钟步行测试）的室内空气净化器， Ludhiana和Thiruvananthapuram。我们还将进行审核分析，以评估是否水平 环境空气污染以及空间/环境因素，使空气净化器对 HF结果。 AIM 2将涉及因果中介分析，以确定PM2.5的降低是否为 与空气净化器与HF结果之间的关系有关。我们还将评估是否 季节性与参与家庭的室内PM2.5浓度的降低相关，并且 我们将在三项研究中确定使用空气净化器对PM2.5空气污染组成的影响 站点。 AIM 3将包括成本效益分析和干预措施的过程评估。 该研究将由具有多样和互补的跨学科研究团队进行 由两名经验丰富的主要研究人员领导的专业知识。我们打算增加现有的知识 创新且可扩展的策略，以改善全球环境和心血管健康。