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The Left and Right Ventricles in Sleep Apnea with COPD

Award Number: F32HL176079
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 08/16/2024
PERIOD OF PERFORMANCE END DATE: 08/15/2027

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The Left and Right Ventricles in Sleep Apnea with COPD - Abstract Dr. Janna Raphelson is a Pulmonary Critical Care fellow at UCSD and she is applying for this F32 grant to further her development as an academic physician scientist. Throughout the time period of this award she hopes to develop an expertise in heart/lung/sleep physiology that will be the foundation of her path to independence as a clinician researcher. She will also pursue proficiency in biostatistical methods and trial design through formal coursework and direct mentoring, and gain exposure to the field of control of breathing. Her specific project for this period will focus on cardiovascular outcomes in patients with comorbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), referred to as overlap syndrome (OVS). To our knowledge, no randomized trials have been performed in OVS leaving a major void regarding how best to treat >1% of the adult US population. The proposed work is a mechanistic study to evaluate the underlying mechanisms behind increased cardiovascular risk in patients with OVS compared to patients with COPD or OSA alone. The central hypothesis is that poor outcomes in OVS vs. COPD or OSA alone are driven by right and left heart remodeling which is more pronounced when exposed to both sustained and intermittent hypoxia in OVS as determined by cardiac MRI imaging metrics. Aim 1 will test the hypothesis that RV remodeling (as measured by RV mass index, primary outcome) will be more elevated in patients with OVS compared to patients with COPD or OSA alone. Given the high vascular risk among afflicted patients, the very high population prevalence of disease, and the lack of current data, further mechanistic research is imperative. Aim 2 will assess the ability of the BODE index, a commonly used clinical tool to predict mortality in COPD, to predict cardiac changes as seen on cardiac MRI. Exercise capacity limitations (an important component of the BODE index) have been linked to myocardial fibrosis and LV remodeling, thus in Aim 2 we hypothesize that high BODE index scores will predict a greater degree of myocardial fibrosis (primary outcome) and increased LV remodeling index (secondary outcome) by cardiac MRI in patients with COPD. This grant period will help launch Janna’s academic career as she is highly focused and deeply committed to making a scientific impact on patients afflicted with pulmonary and sleep related disease. She is working in a highly supportive environment with a mentoring team with a proven track record, and she is passionate about her vision of becoming a leading physician scientist running an NIH funded laboratory in the coming years.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $85,360 )
2025	2025	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	National Center on Sleep Disorders Research	000	2	8/2/2025	NON-COMPETING CONTINUATION	$85,360
														Subtotal = $85,360

Issue Date FY: 2024 ( Subtotal = $81,364 )
2024	2024	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	National Center on Sleep Disorders Research	000	1	7/1/2024	NEW	$81,364
2024	2024	UNIVERSITY OF CALIFORNIA, SAN DIEGO	9500 GILMAN DR	LA JOLLA	CA	92093	SAN DIEGO	USA	National Center on Sleep Disorders Research	001	1	7/1/2024	NEW	$0
														Subtotal = $81,364

Grand Total All Awards = $166,724

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The Left and Right Ventricles in Sleep Apnea with COPD

Award Number: F32HL176079

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 08/16/2024

PERIOD OF PERFORMANCE END DATE: 08/15/2027

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