LONG TERM EFFECTS OF SUBCLINICAL CAD ON CARDIAC FUNCTION

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The South Bay Heart Watch (SBHW) study has established the presence of a definite though imperfect relationship between calcium in the heart (coronary calcium) and heart disease in asymptomatic adults at risk. We have established that this relationship is reduced in diabetic subjects and that there are definite ethnic- specific differences in the presence and amount of coronary calcium, notably between African Americans and other ethnic groups. We have provided evidence that coronary calcium, as a marker for hardening of the arteries, acts independently from markers of inflammation like high sensitivity C reactive protein in predicting heart disease. The objective of this continuation is to examine the effect of baseline calcium and seven-year change in calcium extent on the function of the heart in the now elderly SBHW cohort. This study will also examine the relation between changes in coronary calcium and future heart disease in these elderly subjects. We will accomplish these goals by performing cardiac magnetic resonance imaging (MRI) on 775 South Bay Heart Watch survivors to measure systolic and diastolic function. These measurements are used to determine if the heart is working properly. This proposed research will also examine the relation between changes in coronary calcium scores, including those without MRI scans. The study will be done in two parts, at two different sites. The first part will take place at Harbor-UCLA General Clinical Research Center (GCRC) and the second part at Los Angeles County + University of Southern California (LAC+USC) Imaging Science Center. At the GCRC, blood pressure, heart rate, height and weight will be measured. Blood will be drawn for analysis and an ECG will be done. The MRI will take place during the second part, at the Imaging Science Center. A checklist of all unacceptable implants, devices and prostheses will be used to ascertain that these things are not present in the participant's body before being scheduled for MRI. The All MRI results and any incidental critical findings including, but not limited to, valvular abnormalities, cardiac dysfunction, aneurysm and thrombosis will be forwarded to the Statistical Consultation and Research Center (SCRC). SCRC will send out all reports to the participants. Risk to the subjects is minimal, mainly pain and bruising with blood drawing and possible claustrophobic reaction during the MRI. Claustrophobia is one of the exclusion criteria we have established for this procedure. On the other hand, the subjects will gain greater awareness of their health from their interactions with our staff. They will also be informed of their blood pressures and lipoproteins levels and be given appropriate advice. Therefore the risk: benefit ratio is leaning toward benefit.