There is an urgent need to understand the mechanisms underlying diabetes-induced congenital heart defects (CHDs) through basic science research and biomarker identification in human maternal circulation. Majority of the current research in CHDs is related to genetic analyses; however, environmental factors contribute to the majority of human CHDs, but the underlying mechanism is unknown. There is 60 million worldwide ...more »

There is a need to identify effective interventions for heart, lung, blood, and sleep diseases that could have a transformative population level impact on health inequities if expanded at the national level.

A way for clinical trial investigators to submit ONE application with ONE review and ONE funding decision, and the application would ask for funding from multiple funders (e.g. NHLBI and another IC, NHLBI and PCORI, NHLBI and AHA, NHLBI and CIHR, NHLBI and MRC).

How best to train T1 investigators in using big health care data to test their basic science hypotheses related to heart, lung, blood, and sleep disorders and thus generate sufficient confirmation to justify clinical interventions.

So much basic cardiovascular discovery relies on cell culture models. While cardiac cell lines exist (e.g. HL-1, H9c2), these often poorly model aspects of cardiomyocyte function in-situ (e.g. contractile function, metabolism). In contrast, primary cardiomyocytes isolated from adult animals (especially mice!) are not readily amenable to culture conditions. Even if cells can be kept alive, they are often refractory to ...more »

There is a need to identify and to develop pharmaceutical interventions for patients at risk for sudden cardiac death (SCD).

How do we harness the ongoing “natural experiments” of quality improvement (QI) activities in various healthcare systems to facilitate hypothesis-driven research, improve scientific validity to address questions in clinical trials, and implement and disseminate research results? • Current restrictions in human subjects research regulations • Diversity in approaches and methodology rigor to QI initiatives across different ...more »

Over the last thirty years, our fundamental understanding of the genetics and pathogenesis of congenital heart disease has lagged the tremendous advances in the surgical and clinical care of infants with this group of disorders. We need to close this gap with investigation into the genetic basis of congenital heart malformations to develop new models of disease. The goall is translate an improved molecular genetic and ...more »

One significant challenge if you're a patient or a patient advocate is "who is going to find a life-saving treatment or cure for my disease. Who is going to Pick me and my disease?". The answer is complex but lies within the research community's priorities and interests. Think for a moment like a patient. You are at the mercy of the research community at large, government agencies and companies willing to make your ...more »

There is a need to initiate innovative community trials that are: theory-based; are integrated multi-component, multi-setting, and multi-level (i.e., they target individual, family, community, and built environment); engage community stakeholders; and use community-participatory research principles to enhance cardiovascular health (CVH) in vulnerable and diverse populations.

Hospital cardiorespiratory monitors have great potential to save lives, but are hampered by high false alarm rates that contribute to alarm fatigue. While the long term solution is developing new medical devices that will do this better, few hospitals will benefit from new device innovations in the next decade. In order to better identify early signs of cardiorespiratory deterioration in the hospital at an early stage ...more »

There is a need to develop training programs, mentorship, and collaborations that cross boundaries and prepare researchers for future transdisciplinary needs.

As the current chair of the Research and Training Division, I would like to convey that the AAAAI membership would like the NHLBI to consider the following in the development of its strategic plan:

Will integration of behavior science in clinical research improve effectiveness of interventions for asthma associated with behavioral risk factors? 

How might the NHLBI effectively encourage and support its investigators to collaborate with strategic partners to pursue the early translation of their HLBS discoveries into new diagnostics and therapeutics? The critical challenges to effective early translation of discovery science experienced by the investigator community include: 1. The need for translational skills development, training and guidance 2. Need for ...more »

In the current environment, NIH reviewers actually deter, rather than promote, progress on proposed pre-clinical animal research that is most likely to rapidly translate into clinical breakthroughs in the short term. Scientists should be allowed to focus on critical missing information (roadblocks) needed to accelerate a promising treatment to clinical trials. For instance, at the NHLBI there is currently no study section ...more »