Arousals in obstructive sleep apena (OSA) are life saving, but the associated disruption of sleep is now thought to cause cognitive impairment, increased risk of high blood pressure and atherosclerosis, as well as glucose intolerance and metabolic syndrome. The mechanisms for these downstream effects, however, are not well understood. Can these specific pathophysiological mechanisms be identified, and can ways for mitigating ...more »

If NHLBI set research priorities for pediatric cardiomyopathy and heart failure, it would help investigators better align their application with institute goals.

Can standardized screening, pharmacological/behavioral prevention, and optimized treatment of metabolic complications after allogeneic hematopoietic stem cell transplantation improve outcomes and decrease transplant-related morbidity and mortality?

There is a vital need for evidence-based clinical evaluation tools to assess operative risk and post-operative recovery in the elderly, including biomarkers of physiologic age and a simple/reliable clinical evaluation scheme to determine frailty as a risk factor for poor surgical outcomes.

There is a lack of coordination and collaboration between investigators working to combat nontuberculous mycobacteria infections. NHLBI could provide incentives for research leadership on NTM issues.

Alk 1 or Endoglin deficient endothelial cells promote recruitment of monocytes/macrophages and differentiation of them can play a critical role in development of arteriovenous malformations. Will targeting macrophage recruitment or activation instead of angiogenesis result in greater understanding leading to new therapeutic targets to control disease?

Precision medicine will provide unprecedented opportunities to tailor health care based on knowledge of personal patterns of genetic variations. These variations usually impact protein or RNA sequences, resulting in altered properties. These alterations can result in increased susceptibility to a particular disease or intolerance to common therapeutics. To take full advantage of knowing a patient’s set of gene variations, ...more »

Can we characterize in detail the nature of tissue response to injury, resulting in either aberrant repair or regeneration, to generate predictive algorithms and targetable nodes where manipulation can alter the outcome?

Can we characterize tissue remodeling, repair and injury? What processes are involved that lead to outcome X and dependent on various perturbegens, genetics? How do you translate that?

Much of the hopes for precision medicine (as outlined Dr. Dr. Collins) are based on deriving large amounts of genomic, proteomic, epigenomic and metabolomic data on large cohorts of patients. It will take decades to build these cohorts and even more time to analyze them and derive specific conclusions on how these will help individualize treatments. However, there is a pressing need for how to individualize contemporary ...more »

There is a fundamental gap in our knowledge about many aspects of cardiac sarcoidosis. Isolated cardiac involvement poses a particular challenge for diagnosis. Delay in establishing the correct diagnosis can be long and impacts in outcome since delay in therapy adversely impacts on outcome in these patients. There should be an increased effort to increase our knowledge about cardiac sarcoidosis; it's natural history, ...more »

There is a need to optimize long-term cognitive and functional outcomes in the aging population during and after cardiothorasic surgery, including the development of simple, objective tools to enable risk stratification for vulnerability to neurocognitive deficit. First, cardiothoracic surgical trials and clinical studies should be more "age-representative" and reflect the increasing proportion of the aging population. ...more »

We have all witnessed the success of the National Cancer Institute (NCI) funded Children's Oncology Group - an organization that has made tremendous advancements in the care of children with cancer, very rare compared to sickle cell disease. COG has been able to not only create a database of the numerous studies, but has the unique ability to make "smaller" institutions feel important as is evident by patient enrollment. ...more »