Cardiovascular Disease (CVD) Phenotyping Core

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PROJECT SUMMARY / ABSTRACT: Cardiovascular Disease (CVD) Phenotyping Core The Cardiovascular Disease (CVD) Phenotyping Core will be responsible for advanced subclinical and clinical CVD phenotyping of all participants enrolled in the Precision Cardiovascular Phenotyping and Pathophysiological Pathways in the CARRS cohort (Precision-CARRS) program project grant (PPG). Responsibilities include providing coordination, expertise, and standardization of all elements related to the proposed phenotyping. The overarching goal of the Core is to obtain the highest quality of CVD subclinical and clinical phenotyping in this cohort and further train existing teams and standardize protocols for (a) novel advanced CVD phenotyping in the field, (b) cardiovascular imaging in central facilities, (c) centralized interpretation of all tests, (d) adjudication of subclinical and clinical CVD events and mortality, (e) blood and urine testing and laboratory services, together with quality assurance and quality control. The CVD Phenotyping Core will be based in Delhi, India and will consolidate and augment existing infrastructure and expertise and leverage a decade of collaborative experience between Emory and India’s leading health research institutions. Specific Aim 1 is to formulate and implement plans for accurate and reproducible phenotyping of sub-clinical CVD that includes measures of (i) functional vascular disease assessed as pulse wave velocity and augmentation index that reflect arterial stiffness; (ii) coronary artery calcium, a reflection of subclinical coronary atherosclerosis; (iii) carotid intima-media thickness and plaque; (iv) hepatic steatosis; and (v) sub-clinical myocardial dysfunction measured as left ventricular systolic or diastolic dysfunction using cardiac echo. Aim 2 will implement plans to standardize adjudication of prevalent and incident clinical CVD events to include atherosclerotic events and occurrence of heart failure. Atherosclerotic events will include incident cardiovascular death, myocardial infarction, and stroke or transient ischemic attacks. Secondary outcomes include diagnosis of angina or coronary or peripheral arterial disease, and revascularization. Heart failure occurrences will include diagnosis of symptomatic Stage C or D heart failure. In Aim 3, we will formulate and implement laboratory sample collection and analysis for all biomarkers analyses, to include traditional risk factors, advanced lipid and metabolic measures, and circulating proteins that reflect activation of pathophysiologic processes associated with CVD. The Core will work in close coordination with the Administrative and Field Coordination Core which will administer the field logistics. Acquired data will be transferred to the Data Management and Analysis Core, and provide curated CVD phenotyping data to all 4 PPG projects.