Multi-Ethnic Study of Atherosclerosis-Eye Study

描述(由申请人提供)： 这项建议描述了一项旨在评估视网膜与 微血管特征(例如，视网膜小动脉狭窄、动脉- 静脉划痕和视网膜病变)到亚临床心血管疾病， 临床疾病及其危险因素在多种族研究中的应用 动脉粥样硬化(MESA)，涉及6,500名年龄在45-84岁的男性和女性 不同种族(高加索人、非裔美国人、拉美裔和亚洲人 美国人)。它扩展了新的基于人群的数据，显示了视网膜 根据标准视网膜量化的微血管特征 摄影可以预测女性和女性发生冠心病的可能性 发生中风的男性和女性，与血压和其他因素无关 心血管危险因素。 在目前的研究中，我们建议首先增加视网膜摄影 台地的后续行动。我们将对这些照片进行评分，以确定其存在和 基于标准化方案的视网膜微血管改变的严重程度， 包括基于计算机的视网膜小动脉的定量测量 口径。我们建议测试与视网膜微血管有关的新假说 各种亚临床疾病的特点和微动脉口径 心血管测量(包括定义自 心脏磁共振成像，外周动脉功能定义自 根据血流介导法确定的放射状动脉眼压测量和内皮功能 臂动脉血管扩张)，临床心血管结局 (包括冠心病、充血性心力衰竭和中风)；以及 他们的危险因素(包括高血压和糖尿病)。这项辅助研究 利用MESA心血管数据的结构和丰富，以及 将为微血管的相对贡献提供关键的见解 疾病的病理生理学和自然病史的亚临床与临床 心血管疾病，在具有代表性的男性和女性人群中 不同种族

DESCRIPTION (provided by applicant): This proposal describes a study aimed at evaluating the relation of retinal microvascular characteristics(e.g., retinal arteriolar narrowing, arterio- venous nicking, and retinopathy) to subclinical cardiovascular disease, clinical disease, and their risk factors, in the Multi-Ethnic Study of Atherosclerosis (MESA), involving 6,500 men and women aged 45-84 years of diverse ethnicities (Caucasians, African-Americans, Hispanics and Asian Americans). It extends new population based data that show retinal microvascular characteristics, as quantified from standardized retinal photography, are predictive of incident coronary heart disease in women and incident stroke in men and women, independent of blood pressure and other cardiovascular risk factors. In the current study, we propose adding retinal photography at the first follow-up of the MESA. We will grade these photographs for the presence and severity of retinal microvascular changes based on standardized protocols, including a quantitative, computer-based measurement of retinal arteriolar caliber. We propose to test new hypotheses that link retinal microvascular characteristics and arteriolar caliber to a wide array of subclinical cardiovascular measures (including left ventricular function defined from cardiac magnetic resonance imaging, peripheral arterial function defined from radial artery tonometry, and endothelial function defined from flow-mediated vasodilation of the brachial artery), clinical cardiovascular outcomes (including coronary heart disease, congestive cardiac failure and stroke), and their risk factors (including hypertension and diabetes). This ancillary study capitalizes on the structure and wealth of cardiovascular data in MESA, and will provide critical insights into the relative contribution of microvascular disease to the pathophysiology and natural history of subclinical and clinical cardiovascular disease, in representative populations of men and women of diverse ethnicities