Biology of Long-Term Mechanical Circulatory Support

长期机械循环支持生物学

• 批准号: 7422301
• 负责人: YOSHIFUMI NAKA
• 金额: $ 246.98万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-02-25 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7422301
• 关键词: Biology; Long; Term; Mechanical; Circulatory

DESCRIPTION (provided by applicant): Congestive heart failure (CHF) is a highly prevalent and morbid condition. Randomized trials have shown that the one-year mortality in the subset of heart failure patients with refractory endstage disease ranges from 50 to 75%. Outcomes are worse than those for breast, colon and even lung cancer. Pharmacological treatment offers limited benefit to these patients while heart transplantation is severely limited by the shortage of human donors. Implantable left ventricular assist devices (LVADs) have been developed and clinically investigated in order to fill the obvious gap in our clinical armamentarium. The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Trial recently demonstrated significant survival and quality of life benefit in LVAD recipients compared to medically managed patients. However, the trial also documented the remaining serious adverse events associated with LVAD therapy, which, if overcome, would add substantially to its effectiveness while reducing costs. The proposed SCCOR seeks to elucidate and modulate the biology of the interface between implanted long-term mechanical circulatory support devices and patients with end-stage heart failure. A combination of closely linked animal model and human clinical trials is planned. Studies will evaluate novel interventions directed at the adverse impact of infection and coagulopathy that result from this interface. Furthermore, the feasibility of improving native myocardial function through cellular transplantation in order to facilitate device removal will be explored. While observations and interventions will focus on end-stage heart failure, the exploration of coagulation in this setting could enhance interventions to prevent and manage bleeding and thrombo-embolism while exploration of cellular transplantation has the potential to improve therapeutic approaches to less severe forms of heart failure. The planned research on infection has broader implications for prosthetic implants in general.

描述（由申请人提供）： 充血性心力衰竭（CHF）是一种高度普遍且病态的状况。随机试验 已经表明，难治性末期疾病的心力衰竭患者子集的一年死亡率范围为50％至75％。结果比乳腺癌，结肠甚至肺癌的结局要差。药理学治疗对这些患者的好处有限，而心脏移植受到人类捐助者短缺的严重限制。为了填补我们临床武术中明显的空白，已经开发并进行了临床研究，并进行了临床研究。与医学管理的患者相比，对治疗充血性心力衰竭的机械援助的随机评估最近显示出LVAD接受者的生存率和生活质量受益。但是，该试验还记录了与LVAD疗法有关的剩余严重不良事件，如果克服，这将大大提高其有效性，同时降低成本。 拟议的SCCOR旨在阐明和调节植入的长期机械循环支持设备与终末期心力衰竭患者之间界面的生物学。计划了密切联系的动物模型和人类临床试验的组合。研究将评估针对该界面引起的感染和凝血病的不利影响的新干预措施。此外，将探索通过细胞移植改善本地心肌功能以促进设备去除的可行性。尽管观察和干预措施将集中于终阶段的心力衰竭，但在这种情况下凝血的探索可以增强干预措施，以预防和管理出血和血栓栓塞，同时对细胞移植的探索有可能改善治疗方法，从而以减少严重的心脏衰竭形式。对感染的计划研究对普遍的植入物具有更广泛的影响。

项目成果

Challenges of long-term mechanical circulatory support therapy.

长期机械循环支持治疗的挑战。

• DOI: 10.1586/17434440.5.4.413
• 发表时间: 2008
• 期刊: Expert review of medical devices
• 影响因子: 3.1
• 作者: Latif,Farhana;Cadeiras,Martin;vonBayern,ManuelPrinz;Shahzad,Khurram;Sinha,Anshu;Deng,MarioC
• 通讯作者: Deng,MarioC

Cardiac transplantation: any role left?

• DOI: 10.1016/j.hfc.2007.04.004
• 发表时间: 2007-07-01
• 期刊: Heart failure clinics
• 影响因子: 3.4
• 作者: Cadeiras, Martin;von Bayern, Manuel Prinz;Deng, Mario C
• 通讯作者: Deng, Mario C

Pumps, aqueducts, and drought management: vascular physiology in vascular cognitive impairment.

• DOI: 10.1161/strokeaha.110.595645
• 发表时间: 2011-01
• 期刊: Stroke
• 影响因子: 8.3
• 作者: Marshall RS;Lazar RM
• 通讯作者: Lazar RM

Vaccination with clumping factor A and fibronectin binding protein A to prevent Staphylococcus aureus infection of an aortic patch in mice.

• DOI: 10.1086/590210
• 发表时间: 2008-08-15
• 期刊: The Journal of infectious diseases
• 作者: Arrecubieta C;Matsunaga I;Asai T;Naka Y;Deng MC;Lowy FD
• 通讯作者: Lowy FD

Development of a murine ventricular assist device transcutaneous drive-line model.

小鼠心室辅助装置经皮传动系统模型的开发。

• DOI: 10.1016/j.healun.2008.04.003
• 发表时间: 2008
• 期刊: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
• 作者: vonBayern,ManuelPrinz;Arrecubieta,Carlos;Oz,Sim;Akashi,Hirokazu;Cedeiras,Martin;Naka,Yoshifumi;Deng,MarioC;Lowy,FranklinD
• 通讯作者: Lowy,FranklinD