Cardiovascular Evaluation for the SHS Phase V

SHS V 期心血管评估

• 批准号: 7068380
• 负责人: RICHARD B DEVEREUX
• 金额: $ 65.89万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-08-10 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7068380
• 关键词: Native Americans; atherosclerotic plaque; blood vessel disorder; cardiovascular disorder epidemiology; cardiovascular function; carotid artery; clinical research; cooperative study; diabetes mellitus; disease /disorder proneness /risk; echocardiography; electrocardiography; family genetics; genetic polymorphism; genetic susceptibility; heart dimension /size; heart ventricle; human mortality; human subject; hypertension; linkage mapping; longitudinal human study; myocardial ischemia /hypoxia; obesity; pathologic process; prognosis; ventricular hypertrophy

DESCRIPTION (provided by applicant): Findings in the first 4 Strong Heart Study (SHS) exams (high rates of diabetes [DM] and cardiovascular [CV] events and heritability of arterial cardiac phenotypes [LOD=5.3 for left ventricular (LV) mass index on chromosome 12p]) identify SHS participants as being of unusual importance in understanding CV disease biology. Carotid exams in participants in SHS Phase IV showed substantial progression of atherosclerosis over 4 years and showed heritability of arterial size and stiffness. Phase IV echo's showed near doubling of 'LV hypertrophy and decline in LV function over 8 years from Phase II. Initial 17¿10 months follow-up showed CV events were predicted strongly by discrete carotid plaque but only weakly by intimal-medial thickness (IMT).In SHS Phase V, 3,060 members >15 years old in 3-generation families will be evaluated by carotid and popliteal ultrasound, computerized ECG and echo measures of LV geometry and function. The characteristics of the SHS population and strengths of the investigative groups lead us to focus this renewal to: 1) establish genetic linkage of carotid artery IMT and discrete plaques; 2) assess linkage of LV mass, geometry and newer measures of LV function; 3) examine heritability of ECG measures of cardiac conduction, voltage and repolarization; 4) assess heritability and linkage of popliteal artery IMT and discrete plaque as measures of peripheral arterial disease; 5) assess the separate and joint effects of DM, overweight and hypertension on development of LV hypertrophy and dysfunction over 4 years from the 4thSHS exam; 6) determine the impacts of DM, overweight and hypertension on progression of carotid IMT and discrete plaques since the 4th SHS exam; 7) relate change in ECG measures of LV hypertrophy Andre polarization to changes in echo LV mass and arterial structure and function; 8) assess the prognostic significance of arterial measures made during the 3rd SHS exam and extend analyses of prognostic significance of previously-measured echo and ECG variables; 9) evaluate changes of arterial structure and function in SHS pilot Family Study participants over 8 years and of echo findings over 12 years in cohort members in the SHS Family Study; 10) examine relations of popliteal artery IMT and discrete a thermos to prevalent overt and sub clinical peripheral arterial disease and CV risk factors and 11) evaluate relations of changes in ECG measures of LV hypertrophy, repolarization and ischemia to morbid and mortal events. (End of Abstract)

描述(由申请人提供)： 前4项强心研究(SHS)检查(糖尿病和心血管事件的高发生率以及动脉心脏表型的遗传性[染色体12p上左心室(LV)质量指数的LOD=5.3])的结果表明，SHS参与者在了解心血管疾病生物学方面具有非同寻常的重要性。SHS第四阶段参与者的颈动脉检查显示，动脉粥样硬化在4年内显著进展，并显示动脉大小和僵硬的遗传性。四期超声显示左心室肥厚和左心功能下降在8年内较二期增加近一倍。最初17个月至10个月的随访显示，颈动脉斑块对心血管事件有很强的预测作用，但内中膜厚度(IMT)的预测作用很弱。在SHS V期，3,060名15岁的3,060名成员将通过颈动脉和月国动脉超声、计算机心电和左室几何和功能的回声测量进行评估。根据SHS人群的特点和调查组的优势，我们将重点放在：1)建立颈动脉IMT和离散斑块的遗传联系；2)评估左心室质量、几何形状和更新的左心功能指标的联系；3)检查心脏传导、电压和复极的心电指标的遗传度；4)评估遗传和联系作为外周动脉疾病的指标；5)评估糖尿病、超重和高血压对左心室肥厚和功能障碍发展的单独和联合影响；6)确定自第四次SHS检查以来糖尿病、超重和高血压对颈动脉IMT进展和离散斑块的影响；7)将左室肥厚的心电测量结果与左心室回声质量和动脉结构和功能的变化联系起来；8)评估在第三次SHS检查中测量的动脉测量的预后意义，并扩展对先前测量的回声和心电变量的预后意义的分析；9)评估SHS先导性家庭研究参与者超过8年的动脉结构和功能的变化，以及SHS家庭研究中队列成员超过12年的回声结果；10)检测动脉内膜中膜厚度和离散度与临床常见的外周动脉疾病和心血管危险因素的关系；11)评价左心室肥厚、复极和缺血的心电图指标变化与病死性事件的关系。(摘要结束)