Functional Characterization of Children with Chronic Venous Thromboembolic Disease

慢性静脉血栓栓塞性疾病儿童的功能特征

基本信息

批准号：
10210170
负责人：
Ayesha Zia
金额：
$ 73.47万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10210170
关键词：
3-Dimensional Accelerometer Activities of Daily Living Adherence Adult Aerobic Exercise Affect Affective Anticoagulation Bioenergetics Blood Vessels Blood coagulation Body Weight decreased Body mass index Breathing Cardiac Cardiology Cardiovascular system Child Childhood Chronic Clinical Clinical Treatment Coupling Data Deep Vein Thrombosis Diagnosis Disease Dyspnea Exercise Exertion Fatigue Functional disorder Future Goals Hematology Hospitalized Child Image Impairment Incentives Incidence Intervention K-Series Research Career Programs Leg Limb structure Lower Extremity Lung Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Measurement Measures Metabolic Muscle National Heart, Lung, and Blood Institute Obesity Obstruction Outcome Patients Perfusion Peripheral Phosphocreatine Physical activity Physiological Physiology Play Postphlebitic Syndrome Prospective cohort study Pulmonary Circulation Pulmonary Embolism Pulmonary artery structure Quality of life Recovery Recurrence Research Resolution Respiratory Mechanics Rest Right Ventricular Dysfunction Right ventricular structure Risk Factors Science Secondary to Sensory Shortness of Breath Site Skeletal Muscle Symptoms Syndrome Testing Thinking Thrombosis Thrombus Translational Research Veno-occlusive Venous Venous Thrombosis Ventricular Work adverse outcome clinically relevant clinically significant cohort common symptom deconditioning design disability emotional distress exercise capacity exercise intolerance exercise training experience fitness hemodynamics improved in vivo novel pediatric patients prevent sedentary skeletal muscle metabolism thromboinflammation venous thromboembolism ventilation young adult

项目摘要

PROJECT SUMMARY Venous thrombosis affects approximately 1 in 200 hospitalized children. Important symptoms after deep venous thrombosis (DVT) involving lower extremities and pulmonary embolism (PE) include shortness of breath and exercise intolerance resulting in a decreased quality of life. The mechanisms of these symptoms are unknown. Although patients with venous thrombosis with excise intolerance and exertional dyspnea are generally considered to be deconditioned, our preliminary data challenge this conventional wisdom. Thus, it is presently unclear if exercise intolerance or exertional dyspnea are due to cardiovascular, pulmonary, or limb- muscle dysfunction and whether acquired risk-factors such as deconditioning or obesity contribute to these problems. If we find evidence of deconditioning causing or complicating exercise intolerance or dyspnea, exercise training would be dramatically beneficial; for obesity-related changes in respiratory mechanics, aggressive weight loss measures may be necessary before exercise training can be tolerated. In this application, we will utilize state-of-the-art measures, including 7 Tesla magnetic resonance imaging, at rest and during exercise to investigate central and peripheral mechanisms of these common symptoms. Aim 1 will characterize cardiac limitations; Aim 2, pulmonary and Aim 3, skeletal muscle metabolic aberrations following DVT and PE at 3 and 12 months post-diagnosis in pediatric patients following diagnosis. Our long-term objective is to provide novel and clinically relevant results that could potentially alter approaches for preventing and treating exercise intolerance and dyspnea and improving the quality of life for pediatric patients with VTE.

项目概要大约每 200 名住院儿童中就有 1 人患有静脉血栓。深蹲后的重要症状累及下肢的静脉血栓 (DVT) 和肺栓塞 (PE) 包括呼吸急促呼吸和运动不耐受导致生活质量下降。这些症状的机制未知。尽管静脉血栓形成且伴有切除不耐受和劳力性呼吸困难的患者通常被认为是去条件化的，我们的初步数据挑战了这种传统观点。因此，它是目前尚不清楚运动不耐受或劳力性呼吸困难是否是由于心血管、肺或肢体原因引起的肌肉功能障碍以及后天性危险因素（例如功能失调或肥胖）是否会导致这些症状问题。如果我们发现体能失调导致运动不耐受或呼吸困难或使其复杂化的证据，运动训练将会非常有益；对于肥胖相关的呼吸力学变化，在可以忍受运动训练之前，可能需要采取积极的减肥措施。在这个应用程序中，我们将利用最先进的措施，包括 7 特斯拉磁共振成像，在休息和在运动期间研究这些常见症状的中枢和外周机制。目标1将描述心脏局限性的特征；目标 2，肺部和目标 3，骨骼肌代谢异常儿科患者诊断后 3 个月和 12 个月的 DVT 和 PE。我们的长期目标是提供新颖且临床相关的结果，可能会改变预防方法治疗运动不耐受和呼吸困难，改善静脉血栓栓塞儿科患者的生活质量。