My academic career demonstrates a long-term commitment to patient-oriented research, extensive expertise in the study of the pathophysiology of age related cardiovascular disorders that disproportionately afflict older adults including heart failure with preserved ejection fraction and a successful record in mentoring residents, cardiology fellows and junior faculty in geriatrics and cardiology. My career plan is to expand my research interests to multidisciplinary studies of age related cardiovascular conditions by focusing on: (a) heart failure with a normal ejection fraction, which accounts for more than half of the cases of heart failure in the United States and that afflicts predominately older adults, (b) the emerging phenotype of paradoxically low flow aortic stenosis and (c) TTR cardiac amyloidosis that almost exclusively affects older adults. During the tenure of this award, the applicant will strengthen existing and form new collaborative relationships with basic and clinical investigators at Columbia University and continue a successful mentoring program for young clinical investigators from geriatrics, cardiology and other subspecialty fields of medicine that will foster collaborative interdisciplinary investigations. The latter will be achieved by ongoing development of the Greater New York Geriatric Cardiology Consortium (www.gnygcc.org) aimed at improving the care of older adult patients with cardiovascular disease by performing innovative, investigator initiated, multicenter collaborative clinical investigation. The proposed mentoring program consists of four other components: 1) intensive individualized training in patient oriented research; 2) didactic programs on clinical trial design data analysis, grant writing, and ethics; 3) a group/peer mentoring CoMPAdRE Program (Columbia Mentor Peer Aging Research Program) developmental relationships and 4) critical review by a team of patient oriented research experts and a 360 that will seek to encourage mentees to be the perfect protg and assist them in building a network of evaluation of the PI by mentees and faculty participants. Renewal of this Midcareer Investigator Award in Patient Oriented Research will provide critically needed protected time to achieve these career goals and continuing the mentorship of five current K23 awardees at Columbia University and other mentees at outside institutions and in the pipeline. Columbia provides a strong institutional environment for support of the applicant's career development. The Department of Medicine and Division of Cardiology have committed to protect 50% of the applicant's time for patient oriented research and mentoring. The proposed aims are to evaluate: (1) To determine if the DASH-SR diet post-hospitalization for HF can induce a hedonic shift and alter salt sensitivity in older adults (2) To evaluate whether TTR cardiac amyloid is the cause of the phenotype of HFpEF due to paradoxically low flow aortic stenosis in older adults undergoing TAVR/SAVR, (3) To deploy an online comprehensive geriatric assessment (CGA) instrument and conduct 500 interviews to advance care and improve QOL in older adults with CV disease, (4) To evaluate the utility of a novel measure, the myocardial contraction fraction (MCF) for predicting HFpEF. The proposed studies will advance applicant career development and provide a mechanism by which trainees can acquire the necessary skills to launch a research career and collect data to support grant applications. The ultimate goal is to facilitate the development of a new generation of investigators from both cardiology and geriatrics that can pursue clinical research in the arena of aging cardiovascular disease.

Public Health Relevance

Cardiovascular Disease remains the leading cause of mortality in the United States with a majority of those afflicted being older adults. The broad goa of this program is to train the next generation of academic clinical cardiovascular investigators who will focus on cardiovascular disorders that disproportionately afflict older adults in order to improve the outcomes among these individuals.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AG036778-07
Application #
9134584
Study Section
Special Emphasis Panel (ZAG1-ZIJ-7 (M1)M)
Program Officer
Eldadah, Basil A
Project Start
2010-09-30
Project End
2020-04-30
Budget Start
2016-08-15
Budget End
2017-04-30
Support Year
7
Fiscal Year
2016
Total Cost
$157,032
Indirect Cost
$11,632
Name
Columbia University (N.Y.)
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
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Rubin, Jonah; Steidley, D Eric; Carlsson, Martin et al. (2018) Myocardial Contraction Fraction by M-Mode Echocardiography Is Superior to Ejection Fraction in Predicting Mortality in Transthyretin Amyloidosis. J Card Fail 24:504-511
Rosenblum, Hannah; Castano, Adam; Alvarez, Julissa et al. (2018) TTR (Transthyretin) Stabilizers Are Associated With Improved Survival in Patients With TTR Cardiac Amyloidosis. Circ Heart Fail 11:e004769
Bokhari, Sabahat; Morgenstern, Rachelle; Weinberg, Richard et al. (2018) Erratum to: Standardization of 99mTechnetium pyrophosphate imaging methodology to diagnose TTR cardiac amyloidosis. J Nucl Cardiol 25:347
Bokhari, Sabahat; Morgenstern, Rachelle; Weinberg, Richard et al. (2018) Standardization of 99mTechnetium pyrophosphate imaging methodology to diagnose TTR cardiac amyloidosis. J Nucl Cardiol 25:181-190
Forman, Daniel E; Maurer, Mathew S; Boyd, Cynthia et al. (2018) Multimorbidity in Older Adults With Cardiovascular Disease. J Am Coll Cardiol 71:2149-2161
Milani, Paolo; Dispenzieri, Angela; Scott, Christopher G et al. (2018) Independent Prognostic Value of Stroke Volume Index in Patients With Immunoglobulin Light Chain Amyloidosis. Circ Cardiovasc Imaging 11:e006588
Einstein, Andrew J; Shuryak, Igor; CastaƱo, Adam et al. (2018) Estimating cancer risk from 99mTc pyrophosphate imaging for transthyretin cardiac amyloidosis. J Nucl Cardiol :
Pollack, Lauren R; Goldstein, Nathan E; Gonzalez, Wendy C et al. (2017) The Frailty Phenotype and Palliative Care Needs of Older Survivors of Critical Illness. J Am Geriatr Soc 65:1168-1175
Rubin, Jonah; Alvarez, Julissa; Teruya, Sergio et al. (2017) Hip and knee arthroplasty are common among patients with transthyretin cardiac amyloidosis, occurring years before cardiac amyloid diagnosis: can we identify affected patients earlier? Amyloid 24:226-230

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