Pediatric Sleep Research Program

儿科睡眠研究计划

• 批准号: 8230538
• 负责人: Raouf S. Amin
• 金额: $ 15.06万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8230538
• 关键词: 13 year old; Acute-Phase Proteins; Adult; American; Amyloid Proteins; Biological; Blood Pressure; Blood Vessels; C-reactive protein; Cardiovascular Diseases; Cardiovascular system; Carotid Arteries; Characteristics; Child; Childhood; Chronic; Circadian Rhythms; Clinical; Data; Data Set; Disease; Doctor of Philosophy; Education; Environment; Faculty; Fingers; Fostering; Foundations; Fourier Analysis; Future; Goals; Health; Hour; Hypercapnic respiratory failure; Hypertension; Hypertrophy; Infection; Inflammatory; Knowledge; Lead; Left; Left Ventricular Function; Left Ventricular Mass; Left Ventricular Remodeling; Linear Models; Measures; Mentors; Methods; Modeling; Monocyte Chemoattractant Protein-1; Morbidity - disease rate; Obesity; Obstructive Sleep Apnea; Outcome; Patients; Pediatric Research; Pediatrics; Plasma; Pulmonology; Pulse Pressure; Reporting; Research; Resolution; Secondary to; Serum; Serum amyloid A protein; Severities; Sleep; Sleep Apnea Syndromes; Snoring; Specialist; Statistical Methods; Statistical Models; Structure; Surveys; Syndrome; Testing; Thick; Time; Tonsil; Tonsillar Tissue; Training; Vascular remodeling; Ventricular; Ventricular Remodeling; Wakefulness; base; cardiovascular disorder prevention; career; clinical practice; cytokine; expectation; falls; improved; indexing; inflammatory marker; member; novel; obesity in children; patient oriented research; pressure; programs; public health relevance; radial artery; simulation; ventricular hypertrophy; vessel regression

DESCRIPTION (provided by applicant): The pediatric syndrome of sleep disordered breathing (SDB) encompasses children with simple snoring, obstructive hypoventilation (OH), and varying degrees of obstructive sleep apnea (OSA). The syndrome occurs in more than 12% of all children, with most falling within the mild to moderate range of the severity spectrum. Although the long-term cardiovascular sequelae of severe SDB are well recognized, those that develop secondary to milder forms of SDB remain undefined. The lack of knowledge regarding the long-term cardiovascular morbidity of less severe forms of SDB precludes adequate management of children with the disorder and prevention of cardiovascular disease during adulthood. We build on intriguing preliminary data demonstrating for the first time that compared to controls, lean and obese children with SDB have structural and functional changes of the carotid artery, higher systolic blood pressure and wider pulse pressure. All are important indicators of blood vessel stiffness and determinants of left ventricular load and mass. The goals of this study are threefold: 1) to compare inflammatory cardiovascular disease mechanisms in 5- to 13-year-old children with varying degrees of SDB to those in normal controls; 2) to determine how cytokine levels in plasma relate to those in tonsils; 3) to examine the relationship between inflammatory markers and prognostically important cardiovascular measures such as carotid intima thickness, carotid compliance, pulse pressure, aortic stiffness and left ventricular mass and function before and after adenotonsillectomy. As an important segment of this K 24 application, this research will serve as a platform for the mentees in the program. PUBLIC HEALTH RELEVANCE: The candidate fully recognizes that there is very limited number of pediatric pulmonologists and pediatric sleep specialists who have been able to develop successful academic careers and make novel discoveries in both fields. Recently, the American Board of Pediatrics released the results of the national survey "The Future of Pediatric Education II: Pulmonology " The report showed that on average, the percent effort dedicated to research by pediatric pulmonologist is 14.7%. At all levels of academic careers, such limited effort dedicated to research cannot lead to novel discoveries. Limited training opportunities in patient oriented research compel pediatric pulmonologist and sleep specialists into choosing academic careers with low research expectations. The candidate immediate and long-term goals are to create the mentoring environment for trainees and young faculty members that fosters research that has potential to improve patient health outcomes.

描述（由申请人提供）：睡眠障碍呼吸（SDB）的小儿综合征包括简单打nor，阻塞性不足（OH）和不同程度的阻塞性睡眠呼吸暂停（OSA）的儿童。该综合征发生在所有儿童中超过12％，其中大多数属于严重程度频谱的轻度至中度范围内。尽管重度SDB的长期心血管后遗症已得到充分认可，但发展为继发于温和形式的SDB的后遗症仍然不确定。缺乏关于SDB不太严重形式的长期心血管发病率的知识，这使得成年期间患有疾病和预防心血管疾病的儿童的适当管理。我们建立在有趣的初步数据的基础上，与对照组相比，具有SDB的瘦和肥胖儿童具有颈动脉的结构和功能变化，较高的收缩压和较大的脉压变化。所有都是血管刚度和左心室负荷和质量决定因素的重要指标。这项研究的目标是三重：1）比较5至13岁儿童的炎症性心血管疾病机制与正常对照的儿童与患有不同程度的SDB的儿童； 2）确定血浆中的细胞因子与扁桃体中的细胞因子水平如何相关； 3）检查炎症标志物与预后重要的心血管措施之间的关系，例如颈动脉内膜厚度，颈动脉依从性，脉搏压力，主动脉僵硬，左心室质量以及腺丝切除术之前和之后的功能。作为该K 24应用程序的重要部分，这项研究将成为计划中受训者的平台。 公共卫生相关性：候选人完全认识到，儿科肺科医生和儿科睡眠专家的数量非常有限，他们能够发展成功的学术职业并在这两个领域中发现新颖的发现。最近，美国儿科委员会发布了国家调查“小儿教育的未来II：肺病学”的结果，该报告表明，小儿肺科医生致力于研究的努力的百分比为14.7％。在各个级别的学术职业中，这些致力于研究的有限努力不能导致新发现。以患者为导向的研究的培训机会有限，迫使小儿肺科医生和睡眠专家选择研究期望较低的学术职业。候选人的立即和长期目标是为受训人员和年轻教职员工创造指导环境，以促进有可能改善患者健康结果的研究。