Innovative Clinical Unit MARCAGE
Clinical Unit for the Measurement of Arterial and Cardiac Age and evaluation of Frailty : MARCAGE-FR
Set up of a Clinical Unit to assess, prevent and treat accelerated cardiovascular ageing
Arterial stiffness and cardiac fibrosis are common during the ageing process, leading to a dramatic increase in age-related cardiovascular diseases: hypertension, heart failure, ischemic disease, vascular dementia and arrhythmias. Moreover, arterial age-related alterations contribute to the development of other age-related degenerative diseases such as non-vascular dementia, sarcopenia, osteoporosis, falls etc.
Is it worthy to measure the CV ageing in the older individuals ?
Although arterial ageing concerns all individuals, the extend of this processus is very variable among older people of the same age.
A large number of studies have shown that among old individuals those with the more pronounced cardiac and arterial aging (ex : systolic hypertension, increased aortic stiffness, markers of cardiac fibrosis) are at higher risk for CV complications and other age-related dégénerative diseases. Thsi is observed even in very old individuals although the phenotypes of interest of cardiac and arterial ageing can be modified in the very old especially in presence of frailty and co-morbidities
Necessity for combining measurements of CV ageing and assessement of Frailty
The degree of frailty and co-morbidities modify the role of the different cardiovascular risk factors and the cardiovascular diseases. In addition, these conditions modulate the hierachisation of the holistic management of a patient (risque of polymedication, evaluation of benefit/risk ratios
The aim of the unit for the Measurement ARerial and Cardiac AGEing - FRailty Unit (MARCAGE - FR Unit)
To assess the clinical hemodynamic and biological markers of the arterial and cardiac age and evaluate the degree of frailty in older individuals at high risk for presenting age-related cardiovascular and other degenerative disease. This evaluation will contribute to the prevention of the development of such diseases and their complications, and can contribute to preserve functional capacities and autonomy
Program RHU FIGHT-HF
So far, driven by a trialists’ approach, clinically actionable classifiers of heart failure (HF) are limited to ejection fraction (EF), i.e. HFREF and HFPEF and chronic and acute HF. Despite major progress in
HFREF, mortality is still alarmingly high. No progress has been made in HFPEF and in acute HF. Taking advantage of our teams’ leadership in several on-going major programmes (EU FP7s, Trials, ANR, PHRC), FIGHT-HF calls for a disruptive strategic approach, combining knowledge based on
i) underlying mechanisms, ii) omics and imaging bioprofiling, iii) co-morbidities and iv) holistic disease management to define mechanistically relevant and clinically actionable bioprofiles.
With the ultimate aim of generating new HF classifiers, and to improve patient outcomes, we specifically propose:
1. Identifying and validating new biotargets of relevant underlying mechanisms and associated biomarkers of transition to/progression of HF and its comorbidities, within our areas of expertise
(fibrosis, large arteries, coagulation, TREM-1).
2. Validation of omics, telomere dynamics, and MRI imaging bio-profiling to guide therapy
3. Evaluating disease management strategies taking into account the commonest co-morbidities (Hypertension, Diabetes, Chronic Kidney Disease), frailty in the older ones, the need for remotemonitoring, patient reported outcomes and cost effectiveness.
4. Applying a network-based science approach, data integration and mining of our data-intensive programmes, translating abundant and diverse data into relevant, meaningful and actionable information with the aim of improving effectiveness and efficiency of care and disease management, and generating new hypotheses.
5. Developing and exploiting sustainable and commercially viable novel technologies, biomarkers (multiplex chips, new electro-MRI imaging) and therapies (TREM-1, patient-centred telemedicine loop), through professional IP management, expanding a robust portfolio of patents and R&D support to 4 regional SMEs, including 2 start-ups stemming from our research labs.