Department of Pediatrics, Division of Pediatric Clinical Research, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida 33101, USA.
Curr Opin Pediatr. 2009 Oct;21(5):585-93. doi: 10.1097/MOP.0b013e32832e48df.
Clinical research in pediatric cardiology is under-appreciated and under-funded, yet it has enormous implications for cardiovascular health and healthcare over the entire life-course. Renewed interest in federally funded clinical research makes it timely to propose a comprehensive research agenda that, with its associated rationale, will attract public funds for research into child cardiovascular health and disease.
We propose here a comprehensive pediatric cardiology research agenda consisting of 22 topics and associated research questions. We describe the following five topics in more detail: the need for life-course studies of pediatric cardiac disease and epigenetic factors for later onset of cardiovascular effects; the need to study cardiometabolic disease risk in children; recent pediatric cardiology clinical trials and observational studies; the need to explore the role of physical activity in preventing and treating pediatric cardiology patients; and the need to develop and implement evidence-based interventions to manage pediatric cardiovascular problems.
If the field of pediatric cardiology can adopt a comprehensive research agenda that identifies the most-needed studies, then research could be better coordinated, long-term and collaborative studies would be more readily organized and funded, and the overall financial and scientific efficiency of research in pediatric cardiology would be improved. Targeted research efforts are more likely to realize potential breakthroughs in areas such as genetic and epigenetic screening, biomarkers, cardioprotective strategies, life-course studies, long-term monitoring technologies, environmental influences on disease, evidence-based practice guidelines, and more rapid and safer development of drugs.
儿科心脏病学的临床研究未得到充分重视和资助,但它对整个生命过程中的心血管健康和医疗保健具有重要意义。人们对联邦资助的临床研究重新产生了兴趣,因此及时提出了一项全面的研究议程,该议程及其相关原理将吸引公共资金用于儿童心血管健康和疾病的研究。
我们在这里提出了一个由 22 个主题和相关研究问题组成的全面儿科心脏病学研究议程。我们更详细地描述了以下五个主题:需要进行儿童心脏病和后天心血管影响的表观遗传学因素的生命过程研究;需要研究儿童代谢性心血管疾病风险;最近的儿科心脏病学临床试验和观察性研究;需要探索体育活动在预防和治疗儿科心脏病患者中的作用;以及需要制定和实施循证干预措施来管理儿科心血管问题。
如果儿科心脏病学领域能够采用确定最需要研究的综合研究议程,那么研究就可以更好地协调,长期和协作研究将更容易组织和资助,儿科心脏病学研究的整体财务和科学效率将得到提高。有针对性的研究努力更有可能在遗传和表观遗传学筛查、生物标志物、心脏保护策略、生命过程研究、长期监测技术、疾病的环境影响、循证实践指南以及药物更快和更安全的开发等领域实现潜在突破。