Multi-Ethnic Study of Atherosclerosis-Eye Study

描述（由申请人提供）： 该提案描述了一项旨在评估视网膜病变与视网膜病变之间关系的研究。 微血管特征（例如，视网膜小动脉狭窄 静脉切口和视网膜病）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， 动脉粥样硬化（梅萨），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、非洲裔美国人、西班牙裔和亚裔 美国人）。它扩展了新的基于人口的数据，显示视网膜病变， 微血管特征，如从标准化视网膜 摄影可以预测女性发生冠心病， 男性和女性中风事件，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 梅萨的后续行动。我们会给这些照片打分， 基于标准化方案的视网膜微血管变化的严重性， 包括视网膜小动脉的定量的、基于计算机的测量， 口径的我们建议测试新的假设，视网膜微血管 特征和小动脉口径，以广泛的亚临床 心血管指标（包括左心室功能， 心脏磁共振成像，外周动脉功能定义为 桡动脉张力计和根据血流介导定义的内皮功能 肱动脉血管舒张），临床心血管结局 （包括冠心病、充血性心力衰竭和中风），以及 他们的风险因素（包括高血压和糖尿病）。这项辅助研究 利用梅萨中的心血管数据的结构和财富， 将为微血管的相对贡献提供重要的见解， 疾病的病理生理和自然史的亚临床和临床 心血管疾病，在男性和女性的代表性人群中， 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