RR&D Research Career Scientist Award Application

RR

• 批准号: 10053241
• 负责人: Jonathan N. Myers
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10053241
• 关键词: Abdomen; Abdominal Aortic Aneurysm; Address; Affect; Area; Award; Back; Basic Science; Blood Vessels; Cardiology; Cardiopulmonary; Cardiovascular Diseases; Cause of Death; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Disease; Chronic Kidney Failure; Clinical; Collaborations; Congestive Heart Failure; Coronary; Coronary Arteriosclerosis; Databases; Diagnosis; Diagnostic; Dialysis patients; Disease; Educational Intervention; Elderly; Engineering; Epidemiology; Evaluation; Exercise; Exercise Test; Exercise Therapy; Fostering; Funding; General Population; Goals; Graph; Growth; Guidelines; Health; Health Care Costs; Heart failure; Interdisciplinary Study; Internal Medicine; Journals; Kidney Failure; Left; Medicine; Muscle function; National Heart, Lung, and Blood Institute; New England; Obesity; Outcome; Paper; Patients; Pattern; Peer Review; Persons; Physical Fitness; Physical Function; Physical Medicine; Physical activity; Physiological; Prevalence; Prevention; Productivity; Publications; Radiology Specialty; Recording of previous events; Registries; Rehabilitation therapy; Reporting; Research; Research Project Grants; Resources; Role; Science; Scientist; Seminal; Specialized Center; Spinal cord injury; Stents; System; Time trend; United States National Institutes of Health; Universities; Veterans; Work; cardiovascular health; career; clinical application; clinical center; clinical database; clinically relevant; cognitive performance; cognitive training; cohort; cost; cost effectiveness; cost estimate; design; disability; effectiveness evaluation; exercise intervention; exercise rehabilitation; fitness; functional loss; functional restoration; health organization; heart rhythm; improved; indexing; lifestyle factors; lifestyle intervention; mild cognitive impairment; mortality; multidisciplinary; muscle form; physically handicapped; prevent; prognostic; programs; prospective; relational database; response

The overarching goals of Dr. Myers' research program are to apply exercise therapy and lifestyle intervention to help restore function, reduce disability, and reduce health care costs in Veterans with chronic disease. These areas include diagnostic and prognostic applications of cardiopulmonary exercise testing, and the physiologic effects of multidisciplinary rehabilitation programs in patients with chronic heart failure, coronary artery disease, abdominal aortic aneurysm disease, spinal cord injury, mild cognitive impairment, and chronic renal failure. He is currently PI on two VA RR&D projects, one entitled, “PCI Alternative using Sustained Exercise (PAUSE),” and the other entitled, “Exercise to Prevent Muscle Mass and Functional Loss in Elderly Dialysis Patients (PERFECT).” The PAUSE project extends his work on the clinical applications of rehabilitation in patients with cardiovascular disease. Cardiovascular disease remains the leading cause of mortality in Veterans, and in addition to assessing the physiologic effects of exercise and lifestyle intervention as an alternative to invasive treatment of coronary artery disease, the study addresses the cost effectiveness of non-invasive (lifestyle intervention) vs. invasive (coronary stenting) strategies. The PERFECT trial focuses on the effects of exercise therapy on muscle mass and function in chronic renal failure. Renal failure is an important condition in the VA because of its cost (estimated to be the second most costly condition in the VA), its prevalence (estimated to be 34% higher than the general population), and its devastating effects on physical function and disability. Dr. Myers current work also includes three funded projects involving the effects of exercise therapy in patients with mild cognitive impairment. These studies are designed to evaluate the effectiveness of exercise augmentation strategies along with cognitive training interventions to improve cognitive performance in older Veterans with mild cognitive impairment. Dr. Myers initiated and manages a relational database of clinical, angiographic, and exercise test responses dating back to 1987. This database has been a resource for answering many epidemiologic questions affecting Veterans (termed the Veterans Exercise Testing Study, or VETS). The VETS study is an ongoing, prospective evaluation of Veteran subjects referred for exercise testing for clinical reasons, designed to address exercise test, clinical, and lifestyle factors and their association with health outcomes. Studies from the VETS cohort have addressed the prevalence, temporal trends, and health care costs associated with statin use, obesity, chronic heart failure, cardiac rhythm abnormalities and other chronic conditions, and how these conditions are influenced by fitness and physical activity patterns. Analyses from the VETS cohort have influenced guidelines on exercise testing from major health organizations. He coordinates two other national data bases, a 7-center heart failure cardiopulmonary exercise test consortium, and the AHA/CDC- sponsored Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND). The FRIEND initiative is designed to develop a national fitness registry in order to better inform clinicians and the public about the importance of physical activity and fitness and their role in the prevention of chronic disease. As Co-PI, he recently completed a 6-year NIH-funded Specialized Center of Clinically-Oriented Research (SCCOR) project entitled, “Exercise Therapy in Abdominal Aortic Aneurysm Disease.” The SCCOR program was initiated by the National Heart, Lung, and Blood Institute to foster multidisciplinary research on clinically relevant topics facilitating basic science findings to be more rapidly applied to clinical problems, with an emphasis on prevention, diagnosis, and treatment of a particular disease. This project has particular relevance to Veterans, since it has been shown that the prevalence of abdominal aortic aneurism disease in Veterans >60 years is 14.3%, with potentially lethal consequences if the disease is not treated.

迈尔斯博士研究计划的总体目标是应用运动疗法和生活方式 干预以帮助恢复功能，减少残疾并降低慢性退伍军人的医疗保健成本 疾病。这些领域包括心肺运动测试的诊断和预后应用， 以及多学科康复计划对慢性心力衰竭患者的生理影响， 冠状动脉疾病，腹主动脉瘤疾病，脊髓损伤，轻度认知障碍， 和慢性肾衰竭。他目前是两个VA RR＆D项目的PI，一个标题为“ PCI替代品，使用 持续的运动（停顿）”，另一个题为“锻炼以防止肌肉质量和功能 老年透析患者的损失（完美）。”暂停项目扩展了他在临床上的工作 康复的应用在心血管疾病患者中。心血管疾病仍然是 退伍军人死亡的主要原因，除了评估运动的生理影响和 生活方式干预是替代冠状动脉疾病的侵入性治疗的替代方法，该研究解决了 非侵入性（生活方式干预）与入侵（冠状动脉支架）策略的成本效益。这 完美的试验侧重于运动治疗对肌肉质量和慢性肾功能的影响 失败。肾衰竭是VA的重要条件，因为其成本（估计是第二个 VA中最昂贵的状况，其患病率（估计比一般人口高34％）， 及其对身体机能和残疾的破坏性影响。迈尔斯博士当前的工作还包括三个 资助的项目涉及运动治疗对轻度认知障碍患者的影响。这些 研究旨在评估锻炼策略的有效性以及认知 训练干预措施以改善有轻度认知障碍的老年退伍军人的认知表现。 迈尔斯博士启动并管理临床，血管造影和运动测试反应的关系数据库 可以追溯到1987年。此数据库已成为回答许多流行病学问题的资源 影响退伍军人（被称为退伍军人运动测试研究或兽医）。兽医研究是一项持续的 出于临床原因，对进行运动测试的资深受试者的预期评估，旨在 解决运动测试，临床和生活方式因素及其与健康结果的关联。研究 兽医队列已经解决了与 他汀类药物的使用，肥胖，慢性心力衰竭，心律异常和其他慢性疾病以及如何 这些条件受健身和体育锻炼模式的影响。兽医队列的分析 已经影响了主要卫生组织的运动测试指南。他协调另外两个 国家数据基础，一个7中心的心力衰竭心肺运动测试联盟和AHA/CDC- 赞助健身注册表和练习的重要性：国家数据库（朋友）。朋友 倡议旨在开发国家健身注册中心，以便更好地告知临床医生和公众 关于体育活动和健身的重要性及其在预防慢性疾病中的作用。作为 Co-Pi，他最近完成了一个为期6年的NIH资助的临床研究专业中心 （SCCOR）标题为“腹主动脉瘤性运动疗法”的项目。 SCCOR程序 是由国家心脏，肺和血液研究所发起的，以促进临床上的多学科研究 相关主题促进基础科学发现更快地应用于临床问题，并具有 强调特定疾病的预防，诊断和治疗。这个项目有特殊 与退伍军人相关，因为已经表明腹部主动脉动脉瘤疾病的患病率 退伍军人> 60岁的退伍军人为14.3％，如果未治疗该疾病，可能会带来致命的后果。