The applicant's academic career demonstrates a long-term commitment to patient-oriented research, extensive expertise in the study of the role of the vascular endothelium in the regulation of peripheral vasomotor tone in patients with heart failure, and a successful record in mentoring fellows for careers in patient-oriented research. The career plan of the applicant is to continue expansion of research interests to studies of genetic epidemiology in heart failure, to strengthen existing and form new collaborative relationships with basic and clinical investigators at Yale, and to continue the successful mentoring program for young clinical investigators. The mentoring program consists of three key components: 1) intensive individualized training in patient-oriented research; 2) Yale University didactic programs on clinical trial design, data analysis, grant writing, and ethics; 3) critical review by a team of patient-oriented research experts. Continuation of the Midcareer Investigator Award in Patient-Oriented Research will provide critically needed protected time to achieve these career goals. Yale provides a strong institutional environment for support of the applicant's career development. The Department of Internal Medicine and Section of Cardiovascular Medicine at Yale have committed to protect 50% of the applicant's time for patient-oriented research and mentoring.
The aim of the research plan is to characterize the role of genetic factors in non-familial chronic heart failure (CHF). Detection of gene effects in complex traits like CHF may be facilitated by characterization of intermediate phenotypes with quantitative physiological measurements relevant to the functional effects of specific candidate gene protein products. We propose to prospectively determine the relationship between common DNA variants in vascular regulatory genes and endothelium-dependent flow-mediated dilation of the brachial artery at rest and in response to transient homocysteine-induced oxidative stress in healthy control subjects and subjects with CHF. We hypothesize that common DNA variants in candidate genes that regulate metabolism of nitric oxide, reactive oxygen species, homocysteine and iron are associated with heterogeneity of vascular responses when adjusted for disease severity and other potential confounding clinical, biochemical and dietary factors. The proposed studies will advance applicant career development and provide new insight into pathophysiology of CHF.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24HL004024-09
Application #
7218003
Study Section
Special Emphasis Panel (ZHL1-CSR-Q (O1))
Program Officer
Scott, Jane
Project Start
1999-05-01
Project End
2010-01-31
Budget Start
2007-02-01
Budget End
2008-01-31
Support Year
9
Fiscal Year
2007
Total Cost
$160,759
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
Jelani, Qurat-ul-ain; Katz, Stuart D (2010) Treatment of anemia in heart failure: potential risks and benefits of intravenous iron therapy in cardiovascular disease. Cardiol Rev 18:240-50
Tang, Yi-Da; Hasan, Faisal; Giordano, Frank J et al. (2009) Effects of recombinant human erythropoietin on platelet activation in acute myocardial infarction: results of a double-blind, placebo-controlled, randomized trial. Am Heart J 158:941-7
Tang, Yi-Da; Dewland, Thomas A; Wencker, Detlef et al. (2009) Post-exercise heart rate recovery independently predicts mortality risk in patients with chronic heart failure. J Card Fail 15:850-5
Zheng, Haoyi; Patel, Milan; Cable, Ritchard et al. (2007) Insulin sensitivity, vascular function, and iron stores in voluntary blood donors. Diabetes Care 30:2685-9
Tang, Yi-Da; Rinder, Henry M; Katz, Stuart D (2007) Effects of recombinant human erythropoietin on antiplatelet action of aspirin and clopidogrel in healthy subjects: results of a double-blind, placebo-controlled randomized trial. Am Heart J 154:494.e1-7
Dewland, Thomas A; Androne, Ana Silvia; Lee, Forrester A et al. (2007) Effect of acetylcholinesterase inhibition with pyridostigmine on cardiac parasympathetic function in sedentary adults and trained athletes. Am J Physiol Heart Circ Physiol 293:H86-92
Androne, Ana Silvia; Hryniewicz, Katarzyna; Hudaihed, Alhakam et al. (2006) Comparison of metabolic vasodilation in response to exercise and ischemia and endothelium-dependent flow-mediated dilation in African-American versus non-African-American patients with chronic heart failure. Am J Cardiol 97:685-9
Katz, Stuart D; Hryniewicz, Katarzyna; Hriljac, Ingrid et al. (2005) Vascular endothelial dysfunction and mortality risk in patients with chronic heart failure. Circulation 111:310-4
Hryniewicz, Katarzyna; Dimayuga, Clarito; Hudaihed, Alhakam et al. (2005) Inhibition of angiotensin-converting enzyme and phosphodiesterase type 5 improves endothelial function in heart failure. Clin Sci (Lond) 108:331-8
Zheng, Haoyi; Cable, Ritchard; Spencer, Bryan et al. (2005) Iron stores and vascular function in voluntary blood donors. Arterioscler Thromb Vasc Biol 25:1577-83

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