This five year quantitative research career development award proposes training in two areas: 1) using mathematical modeling of linked longitudinal data (LLD) to better understand complex biological patterns; and 2) cardiology and cardiovascular epidemiology. The Candidate will develop expertise in longitudinal analytic methods and extend these to include the joint modeling of LLD, working under Dr. Scott Zeger at Johns Hopkins University. The Candidate will develop a grasp of anatomy, physiology, cardiology and the ethics of research through coursework and a training program for cardiology fellows under Dr. Joseph Parrillo at Rush Medical Center. Longitudinal techniques will be applied in four research projects. The first three projects build upon ongoing studies while the fourth is designed and executed by the candidate. Project 1: Left ventricular assist devices were developed to help bridge the time to transplant. In an American Heart Association funded study, six standardized quality of life (QOL) measures are being followed in 108 subjects from pre-implant to post-transplant at 8 or more timepoints. Project 1 aims to determine patterns of QOL and how these are related to implant and transplant. Project 2: Study of Women's Health Across the Nation (SWAN) is an NIA funded longitudinal study of the menopausal transition in a cohort of 3300 women from five ethnic groups in 7 seven cities. Project 2 aims to describe the phases of the menopausal transition in terms of hormonal patterns. Project 3: A SWAN substudy funded by NHLBI examines the development of subclinical atherosclerosis during the menopausal transition. Carotid ultrasound, electron beam tomography of coronary and aorta, vascular stiffness and endothelial function will be measured each year for three years. Project 3 aims to describe the changes in subclinical disease patterns as women pass through the menopausal transition. Project 4: Current models of risk in unstable angina focus on individual predictors available at admission. Additional routine clinical information will be collected during the first 24 hours, such as vital signs and ST monitoring via serial electrocardiograms. This data will be analyzed as LLD to determine if recognizing typical patterns of change during the first 24 hours can improve risk estimation. The Candidate will develop the necessary skills to be an independent researcher in biostatistics, cardiovascular epidemiology and cardiology through the training and research projects.
