The Incidence and Progression of Peripheral Venous Disease

周围静脉疾病的发病率和进展

• 批准号: 7416664
• 负责人: MICHAEL H CRIQUI
• 金额: $ 72.84万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7416664
• 关键词: Accounting; Ache; Address; Age; Cardiovascular Diseases; Categories; Color; Data; Deep Vein Thrombosis; Depth; Diagnosis; Disease; Disease Progression; Documentation; Ethnic Origin; Etiology; Evaluation; Event; Expenditure; Genetic; Incidence; Inflammation; Inflammatory; Invasive; Leg; Localized; Measures; Medical Records; Morbidity - disease rate; Muscle Cramp; Obesity; Obstruction; Pathologic; Performance; Peripheral; Pharmaceutical Preparations; Physical Examination; Physical activity; Plasma; Population; Population Study; Prevalence; Prevalence Study; Prevention strategy; Progressive Disease; Pruritus; Pulmonary Embolism; Quality of life; Reflux; Reporting; Restless Legs Syndrome; Risk Factors; Role; SF-36; Score; Seminal; Signs and Symptoms; Skin; Swelling; Symptoms; Thrombosis; Ultrasonography; Variant; Varicosity; Venous; Venous Insufficiency; Venous Thrombosis; Woman; clinical Diagnosis; cohort; disorder control; follow-up; indexing; innovation; men; mortality; sex; valvular insufficiency

DESCRIPTION (provided by applicant): Venous disease is common, a major cause of morbidity and occasionally mortality, and accounts for 30% of all cardiovascular disease expenditures. Venous disease definitions have often confused symptoms and signs with pathophysiologic abnormalities. In our previous venous prevalence study, using hierarchical categories, we accurately established in a multi-ethnic population the presence or absence, and degree of concordance, of visible disease -normal (NL), varicose veins (W), trophic changes (TCS), and functional disease (reflux or obstruction) by Duplex ultrasound -normal, superficial functional disease (SFD), deep functional disease (DFD). We documented the importance of leg-specific assessment, and reported prevalence by age, sex, and ethnicity, and the association of venous disease with risk factors, symptoms, and quality of life. To date, there has been no rigorous assessment of the incidence of venous disease in a defined population. The specific aims are: First, to determine the ten-year incidence of new venous disease, and progression of existing venous disease, in 1200 men and women (2400 legs) from our study population with known venous disease status at baseline. Incident disease will be defined as transition from visibly and functionally normal to W, TCS, SFD, or DFD. Progressive disease will be defined as a transition from W to TCS or from SFD to DFD, or progression within these categories. We will separately determine the incidence of venous thrombosis and pulmonary embolism. Second, to evaluate risk factors for incident/progressive venous disease, focusing on risk factors potentially biased by "reverse causality" in prevalence studies; i.e., venous disease may cause rather than, or as well as, result from the risk factor; e.g., physical activity, obesity, and medication use, and selected stored plasma markers with a focus on thrombotic and inflammatory factors. Such data could impact prevention strategies. Third, to determine the temporal relation of symptoms with venous disease; i.e., can symptoms precede (as well as follow) incident/progressive disease? Such data could be important in clinical diagnosis of venous disease. Fourth, to evaluate change in the SF-36, a quality of life index, with incident/progressive venous disease, controlled for non-venous morbidity, to provide quantitative estimates of the burden of incident and progressive venous disease. This application builds on the seminal findings in our prevalence study, and since no such incidence data exist, is original and innovative.

简介(申请人提供)：静脉疾病很常见，是发病率和偶尔死亡的主要原因，占所有心血管疾病费用的30%。静脉疾病的定义经常将症状和体征与病理生理异常混淆。在我们之前的静脉患病率研究中，使用分层分类，我们通过双功超声准确地在多民族人群中建立了可见疾病-正常(NL)、静脉曲张(W)、营养改变(TCS)和功能性疾病(返流或梗阻)-正常、浅层功能性疾病(SFD)、深层功能性疾病(DFD)的存在或不存在以及和谐程度。我们记录了腿部特异性评估的重要性，并按年龄、性别和种族报告了患病率，以及静脉疾病与危险因素、症状和生活质量的关联。到目前为止，还没有对确定人群中的静脉疾病发病率进行严格的评估。具体目标是：首先，从我们的研究人群中确定1200名男性和女性(2400条腿)新的静脉疾病的十年发病率和现有静脉疾病的进展。突发疾病将被定义为从外观和功能正常过渡到W、TCS、SFD或DFD。进行性疾病将被定义为从W向TCS或从SFD到DFD的过渡，或在这些类别中的进展。我们将分别测定静脉血栓和肺血栓的发生率。第二，评估偶发/进行性静脉疾病的风险因素，重点放在患病率研究中可能被“反向因果关系”偏向的风险因素；即静脉疾病可能引起而不是风险因素，或者也可能是风险因素的结果；例如，体力活动、肥胖和药物使用，以及选择储存的血浆标志物，重点放在血栓和炎症因素上。这些数据可能会影响预防战略。第三，确定症状与静脉疾病的时间关系；即，症状是否先于(以及跟随)事件/进展性疾病？这些数据可能对静脉疾病的临床诊断有重要意义。第四，评估SF-36的变化，SF-36是一种生活质量指数，在控制非静脉疾病发病率的情况下，对发生/进行中的静脉疾病进行控制，以提供对发生和进行中的静脉疾病负担的定量估计。这一应用建立在我们流行率研究中的开创性发现之上，由于没有这样的发病率数据，因此是原创和创新的。