Cardiac MR of Subclin CVD: Impact of Age

Subclin CVD 的心脏 MR：年龄的影响

• 批准号: 6797421
• 负责人: WARREN J MANNING
• 金额: $ 39.71万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6797421
• 关键词: acute phase protein; age difference; atherosclerosis; bioimaging /biomedical imaging; cardiovascular disorder diagnosis; cardiovascular disorder epidemiology; cardiovascular imaging /visualization; clinical research; diagnosis design /evaluation; disease /disorder proneness /risk; early diagnosis; family genetics; heart imaging /visualization /scanning; human genetic material tag; human subject; magnetic resonance imaging

DESCRIPTION (Verbatim from the Applicant's Abstract): Coronary heart disease and stroke are leading causes of mortality for men and women in the United States. Our current understanding of the pathogenesis of and the risk factors for cardiovascular disease (CVD) is derived largely from prospective studies of clinically overt disease. Unfortunately, clinical risk factors for CVD defined by these methods fail to predict a large proportion of CVD events, and some subjects at high clinical risk fail to develop overt disease. Subclinical disease precedes clinical events by years/decades but is difficult to quantify. For example, left ventricular hypertrophy (LVH) and aortic atherosclerosis are strong predictors of CVD events, but are difficult to accurately non-invasively quantify, especially among the elderly and overweight subjects (both growing populations in the U.S.). MRI perrnits accurate assessment of cardiac anatomy/function and subclinical aortic atherosclerosis. The underlying hypothesis of this proposal is that subclinical CVD is a precursor to overt CVD, and that MRI measures of subclinical aortic and cardiac anatomic disease are superior for the characterization of risk as compared with current measures of risk factors as well as more conventional imaging (e.g., carotid ultrasound, echo). Longitudinal/time-averaged indexes of all established risk factors for CVD have been collected in the Framingham Heart Study (FHS). These time-averaged indexes are stronger predictors of clinical CVD than single measures. In a Pilot study of 312 FHS Offspring subjects, MRI measures of LV mass were successfully acquired in a larger proportion of subjects than echo, and MR evidence of LVH and subclinical aortic disease correlated more strongly (than echo and carotid ultrasound measures) with these time-averaged indexes. Application of MRI methods in the FHS offers an opportunity to identify subclinical atherosclerosis and LVH in this well-characterized cohort and to relate these data with conventional imaging measures already acquired in this cohort. Importantly, the near-concurrent acquisition of brain MRI/neuropsychologic examination in the same FHS cohort offer the unique contemporaneous opportunity to examine subclinical cerebrovascular disease with MRI indexes of subclinical atherosclerosis. We propose to expand our Pilot study to perform heart and thoracic/abdominal aorta MRI studies in 2400 FHS participants to allow for identification of individual CVD risk factors for subclinical atherosclerosis. These population-based data will extend our knowledge of the distribution and severity of atherosclerosis in adult men and women and their relations to existing echo, carotid ultrasound and brain MRI measures. This study provides the rare opportunity to examine associations of quantitative MRI measures of aortic atherosclerosis and LVH with both cross-sectional and time-averaged measures of individual atherosclerotic risk factors (e.g., blood pressure, cigarette smoking, and cholesterol) and with novel inflammatory markers (e.g., C-reactive protein, MCP-1). Further, because the FHS consists of hundreds of sibships for which a DNA repository has been established, we propose to determine the heritability of MRI indexes of atherosclerosis and LVH, laying the groundwork for future genetic studies.

描述（逐字摘自申请人摘要）：冠心病 和中风是美国男性和女性死亡的主要原因 国家。我们目前对发病机制和危险因素的了解 心血管疾病（CVD）的治疗主要来自前瞻性研究 临床上明显的疾病。不幸的是，CVD 的临床危险因素已明确 这些方法无法预测大部分 CVD 事件，并且有些方法 具有高临床风险的受试者未能发展出明显的疾病。亚临床 疾病先于临床事件数年/数十年，但难以量化。 例如，左心室肥厚（LVH）和主动脉粥样硬化 CVD 事件的有力预测因子，但难以准确无创地预测 量化，特别是在老年人和超重受试者中（两者都在增长） 美国的人口）。 MRI 可准确评估心脏状况 解剖/功能和亚临床主动脉粥样硬化。底层的 该提案的假设是，亚临床 CVD 是显性 CVD 的前兆。 CVD、亚临床主动脉和心脏解剖疾病的 MRI 测量 与当前措施相比，在风险特征描述方面具有优势 危险因素以及更传统的成像（例如颈动脉超声， 回声）。 所有已确定的 CVD 危险因素的纵向/时间平均指数 被弗雷明汉心脏研究（FHS）收集。这些时间平均指数 比单一指标更能预测临床 CVD。在一项试点研究中 对 312 名 FHS 后代受试者成功进行了 MRI 测量 LV 质量 与回波和 MR 证据相比，在更大比例的受试者中获得 LVH 证据 和亚临床主动脉疾病的相关性更强（比回声和颈动脉疾病相关性更强） 超声测量）与这些时间平均指数。磁共振成像的应用 FHS 中的方法提供了识别亚临床的机会 动脉粥样硬化和 LVH 在这个特征明确的队列中，并将这些联系起来 在此队列中已经获得的常规成像测量数据。 重要的是，脑 MRI/神经心理学的几乎同时采集 在同一 FHS 队列中进行考试提供了独特的同时期机会 通过亚临床脑血管病的MRI指标检查亚临床脑血管病 动脉粥样硬化。 我们建议扩大我们的试点研究以进行心脏和胸/腹部 对 2400 名 FHS 参与者进行主动脉 MRI 研究，以识别 亚临床动脉粥样硬化的个体CVD危险因素。这些 基于人口的数据将扩展我们对分布和分布的了解 成年男性和女性动脉粥样硬化的严重程度及其与 现有的回声、颈动脉超声和脑部 MRI 测量。这项研究提供了 难得的机会来检查定量 MRI 测量的关联 主动脉粥样硬化和 LVH 的横截面和时间平均 个体动脉粥样硬化危险因素的测量（例如血压、 吸烟和胆固醇）以及新型炎症标志物（例如， C反应蛋白，MCP-1)。此外，由于 FHS 由数百个 对于已建立 DNA 库的同胞，我们建议 测定动脉粥样硬化、LVH MRI指标的遗传性，奠定 为未来的遗传学研究奠定基础。