Mass General Brigham HeartShare Clinical Center

麻省总医院布里格姆 HeartShare 临床中心

基本信息

批准号：
10679064
负责人：
Akshay Suvas Desai
金额：
$ 28.38万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
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：
2021-09-10 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10679064
关键词：
Academic Medical Centers Amyloid Amyloidosis Artificial Intelligence Bioinformatics Biological Markers Blood Vessels Blood gas Blood specimen Cardiac Cardiopulmonary Classification Clinical Clinical Pathways Clinical Research Clinical Treatment Clinical Trials Clinical assessments Cognition Collaborations Computerized Medical Record Coupled Data Development Diagnosis Dyspnea EFRAC Echocardiography Electronic Health Record Enrollment Epidemiology Evaluation Exercise Exercise Test Functional disorder Gases General Hospitals Geriatrics Heart failure Hospitals Human Subject Research Image Impairment Individual Institution Integrated Health Care Systems Intervention Trial Laboratories Leadership Lung Magnetic Resonance Imaging Massachusetts Measurement Mentors Morbidity - disease rate Multimodal Imaging Musculoskeletal National Heart, Lung, and Blood Institute Observational Study Operations Research Pathway interactions Patient Care Patient Recruitments Patients Pattern Peripheral Pharmacotherapy Phenotype Physiologic Monitoring Physiological Physiology Plasma Population Population Study Positron-Emission Tomography Principal Investigator Program Evaluation Proteomics Protocols documentation Research Research Infrastructure Research Personnel Rest Sampling Signal Transduction Site Structure Testing Therapeutic Intervention Translating Validation Woman adjudication arterial tonometry body system cardiovascular imaging clinical care clinical center clinical investigation cohort cost effective data quality design effective therapy experience frailty heart function heart imaging heart preservation hemodynamics improved insight medical specialties member metabolomics multidisciplinary multimodality novel novel therapeutic intervention observational cohort study participant enrollment patient population pharmacologic population based preservation pro-brain natriuretic peptide (1-76)programs public health relevance recruit screening transcriptomics unsupervised learning

项目摘要

Project Summary Heart failure with preserved ejection fraction (HFpEF) comprises approximately half of all HF and is a highly morbid condition. Pharmacotherapies that are effective in treating HF with reduced ejection fraction have more modest if any beneficial impacts on HFpEF, potentially owing to heterogeneous definitions of HFpEF and limited understanding of optimal pathways to target in HFpEF. Our team of investigators has extensive experience in HFpEF human subjects research. Complementary Dyspnea and Heart Failure Evaluation Programs attract referral of HFpEF patients as well as dyspneic control patients without HFpEF to the Massachusetts General Hospital and Brigham and Women’s Hospital (“Mass General Brigham, MGB”). In addition, our team is highly engaged in assessing therapeutic interventions for HFpEF through robust clinical trials programs. The MGB HeartShare Team’s PIs are responsible for HFpEF clinical trial conceptualization, design, implementation, and endpoint adjudication via established core laboratories in echocardiography, cardiopulmonary exercise testing, advanced cardiovascular imaging, all of which could be used to support HeartShare. Our team also has expertise in working with MGB-based electronic health record data, population study data, and clinical trials that inform our understanding of HFpEF. Our group has used comprehensive cardiopulmonary exercise testing (CPET) to simultaneously quantitate invasive hemodynamics, blood gases, cardiac function, arterial tonometry and gas exchange patterns during exercise in individuals with conventionally defined HFpEF. We have begun to delineate contributions of impaired cardiac, pulmonary, vascular, and peripheral musculoskeletal reserve capacity that are not evident at rest. Our single-center HFpEF phenotyping study already consists of >700 patients with HFpEF subjected to uniform phenotyping (echocardiography, NT-proBNP, multi-site blood sampling at rest and with exercise and comprehensive CPET). In Aim 1 we will assemble a collaborative multidisciplinary investigative team capable of recruiting, phenotyping, and retaining ≥250 HFpEF patients in the HeartShare Program while also drawing from experience with core lab oversight, bioinformatic expertise in electronic medical record research, and leadership of network, population cohort, and clinical trial research relevant to HFpEF. In Aim 2 we will refine the diagnosis and subclassification of HFpEF through comprehensive clinical assessment including multi-modality imaging of cardiac structure and function, perturbational testing with exercise to probe multi-organ system physiologic reserve and longitudinal remote physiologic monitoring and assessment of frailty and cognition. We will also expand on our experience with creation of omics-based signatures of pathophysiologic states in HFpEF and deploy unsupervised machine learning approaches to the derived data. HeartShare will enhance understanding of HFpEF and our team is poised to translate improved understanding of HFpEF subtypes into new therapeutic intervention trials in HFpEF.

项目概要射血分数保留的心力衰竭 (HFpEF) 约占所有心力衰竭的一半，是一种高度有效治疗射血分数降低的心力衰竭的药物疗法有更多。对 HFpEF 的有益影响即使有，也是有限的，可能是由于 HFpEF 的定义不同且有限我们的研究团队在了解 HFpEF 的最佳靶向途径方面拥有丰富的经验。 HFpEF 人类受试者研究吸引了补充性呼吸困难和心力衰竭评估项目。将 HFpEF 患者以及无 HFpEF 的呼吸困难控制患者转诊至马萨诸塞州总医院医院和布莱根妇女医院（“麻省布里格姆总医院，MGB”）此外，我们的团队高度评价。 MGB 致力于通过稳健的临床试验项目评估 HFpEF 的治疗干预措施。 HeartShare 团队的 PI 负责 HFpEF 临床试验的概念化、设计、实施和通过已建立的超声心动图、心肺运动测试、先进的心血管成像，所有这些都可以用于支持 HeartShare 我们的团队也拥有专业知识。处理基于 MGB 的电子健康记录数据、人口研究数据以及提供信息的临床试验我们对 HFpEF 的理解是，我们的团队使用了综合心肺运动测试 (CPET)。同时定量有创血流动力学、血气、心功能、动脉张力测量和气体我们已经开始描述患有传统定义的 HFpEF 的个体运动期间的交换模式。心脏、肺、血管和周围肌肉骨骼储备能力受损的贡献我们的单中心 HFpEF 表型研究已包含超过 700 名 HFpEF 患者。进行统一的表型分析（超声心动图、NT-proBNP、静息时和伴随时的多部位血液采样）在目标 1 中，我们将组建一个协作性多学科调查。团队能够在 HeartShare 计划中招募、分析和保留 ≥250 名 HFpEF 患者，同时还借鉴了核心实验室监督、电子病历方面的生物信息专业知识的经验目标 2 中与 HFpEF 相关的研究和网络、人群队列和临床试验研究的领导力。我们将通过全面的临床评估完善 HFpEF 的诊断和亚分类，包括心脏结构和功能的多模态成像、运动微扰测试以探测多器官系统生理储备和纵向远程生理监测以及虚弱和评估我们还将扩展我们创建基于组学的病理生理学特征的经验。 HFpEF 中的状态并对派生数据部署无监督机器学习方法。增强对 HFpEF 的理解，我们的团队准备转化对 HFpEF 的更好理解 HFpEF 的新治疗干预试验中。