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Learn how your heart works
Heart is basically a pump which pumps blood to all parts of our body. It works all day along. Heart having the size of our fist is located between the two lungs nearly in the middle of the chest, towards the left side and weighs about 250-300 grams.
Symptoms of heart failure may differ in different people. However, in most people the most important symptoms are dyspnea on exertion, palpitations, edema etc
Centre for Advanced Research and Excellence in Heart Failure
CARE scheme was formulated by ICMR to encourage in-depth research on an identified research problem with the aim of generating new knowledge and having a better understanding in different disciplines in the country.
Biobanks are an organized collection of biological material and associated data, which is a valuable resource available to all bona fide researchers conducting various research for betterment of science and society.
A National Centre of Excellence established byThe Indian Council of Medical Research (ICMR)
The Centre for Advanced Research and Excellence (CARE) scheme was formulated by ICMR to encourage in-depth research on an identified research problem with the aim of generating new knowledge and having a better understanding in different disciplines in the country. Heart failure is a key area identified in the country by ICMR and the CARE in Heart Failure is initiated in Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST). The research activities of the proposed CARE in HF at the SCTIMST will be a role model for future research initiatives in India.
Biobanks, as repositories for the storage of biological material and its corresponding data, are becoming important tools and instruments in developing more personalized, and prognostic approach in disease management. The facility which we are planning is the first HF biobank in India. We propose to establish a biobank as a major component of the CARE - HF. As part of this activity, we intend to develop SOPs for sample processing, archiving and retrieval for analyses. We plan to collect tissue specimens and body fluids, store them and use for different research projects.
Hypertrophic cardiomyopathy is a common cardiomyopathy where the heart muscle gets hypertrophied and patients initially develop Heart Failure Preserved Ejection Fraction. We plan to identify the association of genetic mutations and the phenotypic expression of hypertrophic cardiomyopathy (HCM) in order to recommend a population specific mutation panel to assist diagnostic and/or predictive testing for HCM among Indian patients.
NT-pro BNP is biomarker which is approved for evaluation of patients with HF. Frequent estimation of blood levels of NT-proBNP is key to diagnose HF, and optimally introduce and titrate new pharmacological agents for the management of HF as it has good prognostic discriminatory power. The current issue is the cost of the test, which prevents its routine use. We propose to develop and clinically validate a point-of-care device for the measurement of NT-proBNP in outpatient settings, which can do the estimation at affordable costs. A cheaper way of estimation of NT-proBNP in outpatient settings will help to improve the accessibility of this test in a wider population of HF patients.
Disease registries are an efficient way to collect epidemiological data on etiological and diagnostic characteristics, and therapeutic practice patterns of disease conditions. Findings from the disease registries often help clinicians and policymakers to promote understanding about potential causes, identify associations, facilitate early and accurate diagnosis, assess the uptake of evidence-based guideline recommendations and identify gaps in management. With the larger goal of describing the real-world situation in terms of pattern, treatment practices and clinical outcomes, we are developing a national database of HF patients after compiling data from the already established and ongoing HF registries in India. Our aim is to gather data from over 20,000 HF patients and make them available for research for a wider network of potential researchers.
The aim is to examine the effect of affliction with HF and related disability experienced by households on their economic well-being. This study will specifically examine the following with respect to HF treatment and care - (a) household healthcare expenditure including out-of-pocket expenditure(b) financing mechanisms used by households, (c) the impoverishing effects of health expenditures, and (d) the effect of HF on household income, productivity and functional limitations. These study objectives will be examined across socioeconomic and age groups, family size, area of residence (urban vs rural) across different states in India with varying socio-economic development.
Experimental studies are essential to demonstrate the effectiveness of quality improvement initiatives. Given that a large proportion of HF patients are receiving less than optimal care, quality improvement initiatives are highly relevant in India. The primary objective of the proposed study is to assess the differences in quality of life across different types of HF (for eg; HF with preserved Ejection Fraction (HFpEF), HF with mid-range EF (HFmrEF) and HF with reduced ejection fraction (HFrEF). Whether there are any differences in QOL based on Gender, urban-rural, socioeconomic strata and level of education will be also assessed as part of the study. We plan to translate and linguistically validate various available tools to assess the QOL.
We proposed one experimental study as part of the CARE in HF. The study is a complex 2X2 factorial trial to simultaneously evaluate the efficacy of two rehabilitation strategies (physical activity training and cognitive behavioural therapy) in HF management on mortality outcomes. This study will be initiated in the second year of the project, ie. 2020.
CARE in HF
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