Aortic Calcium: epidemiology and progression

描述(申请人提供)：通过计算机断层扫描测量的主动脉钙比心血管疾病(CVD)的其他亚临床(即无症状)标记物发生得更早，范围很广，在女性中很常见。大动脉的大小和相对缺乏运动产生的图像伪影使其成为放射定量成像的理想选择。这项应用与动脉粥样硬化的多种族研究(MESA)相协调，MESA是一项大型前瞻性流行病学研究，调查多种亚临床心血管疾病措施和心血管疾病危险因素。MESA的亚临床测量包括冠脉钙化、颈动脉超声、心脏磁共振成像和踝关节/臂部血压指数。广泛的心血管疾病危险因素测量既包括传统的危险因素，也包括新的测量方法，如炎症和遗传标志物。 这一应用的主要长期目标是确定主动脉钙的流行病学。将对随机挑选的2000名(总共6500名)MESA参与者进行研究。需要解决的问题包括：主动脉钙化进展的预测因素；主动脉钙化和主动脉钙化进展与其他亚临床心血管指标、心血管危险因素和人口统计学的关系；以及主动脉钙的预后意义。该项目有三个主要的具体目标：1)预测作为其他亚临床心血管指标和心血管危险因素的函数的主动脉横截面钙负荷；2)作为其他亚临床心血管指标和心血管危险因素的函数预测主动脉钙化进展；以及3)作为选定的亚临床心血管指标和心血管危险因素的进展的函数预测主动脉钙进展。这两个次要的具体目标是：1)比较男性和女性以及四个主要种族(白人、西班牙裔、黑人和亚洲人)的三个主要特定目标的结果；2)提供一个数据库，用于未来评估主动脉钙化和/或主动脉钙化进展是否独立地预测随后的心肌梗死、中风和其他心血管事件。 这一应用可能对心血管健康具有重大意义。“全身扫描”包括测量主动脉钙，已成为一种流行的诊断工具。这一应用与MESA提供的广泛的亚临床和风险因素测量相结合，将独特地确定测量主动脉钙在心血管风险评估中的独立和递增的重要性。

DESCRIPTION (provided by applicant): Aortic calcium, measured by computed tomography, occurs earlier in life than other subclinical (that is, asymptomatic) markers of cardiovascular disease (CVD), shows a wide range, and is common in women. The large size of the aorta and relative lack of image artifact from motion make it ideal for radiographic quantitative imaging. This application is coordinated with the Multi-Ethnic Study of Atherosclerosis (MESA), a large prospective epidemiologic study investigating multiple subclinical CVD measures and CVD risk factors. Subclinical measures in MESA include coronary calcium, carotid ultrasound, cardiac magnetic resonance imaging, and the ankle/brachial blood pressure index. The extensive CVD risk factor measurements include both traditional risk factors and newer measures such as inflammatory and genetic markers. The primary long-term objective of this application is to determine the epidemiology of aortic calcium. 2000 randomly selected (from 6500 total) MESA participants will be studied. Questions to be addressed include predictors of aortic calcium progression; associations of aortic calcium and aortic calcium progression with other subclinical CVD measures, CVD risk factors, and demographics; and the prognostic significance of aortic calcium. The project has three primary specific aims: 1) to predict the cross-sectional aortic calcium burden as a function of other subclinical CVD measures and CVD risk factors; 2) to predict aortic calcium progression as a function of other subclinical CVD measures and CVD risk factors, and 3) to predict aortic calcium progression as a function of progression of selected subclinical CVD measures and CVD risk factors. The two secondary specific aims are 1) to contrast the results of the three primary specific aims for men vs. women, and for four major ethnic groups (White, Hispanic, Black, and Asian); and 2) to provide a database for future evaluation of whether aortic calcium and/or aortic calcium progression independently predict subsequent myocardial infarction, stroke, and other CVD events. This application potentially has major significance for cardiovascular health. "Total body scanning" including measurement of aortic calcium, has become a popular diagnostic tool. This application, in conjunction with the extensive subclinical and risk factor measurements available in MESA, will uniquely allow determination of the independent and incremental importance of measuring aortic calcium in CVD risk assessment.