Epidemiologic Study of Sick Sinus Syndrome

病态窦房结综合征的流行病学研究

• 批准号: 8174838
• 负责人: Alvaro Alonso
• 金额: $ 18.96万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8174838
• 关键词: Accounting; Address; Adrenergic beta-Antagonists; Affect; African American; Age; Atherosclerosis; Atrial Fibrillation; Biological Markers; Blood; Blood Pressure; Body mass index; Brain natriuretic peptide; C-reactive protein; Calcium Channel Blockers; Candidate Disease Gene; Cardiac; Cardiomyopathies; Cardiovascular Diseases; Cardiovascular system; Cholesterol; Chronic Kidney Failure; Clinical; Code; Cohort Studies; Communities; Coronary heart disease; Country; Data; Death Rate; Diabetes Mellitus; Diet; Digitalis preparation; Disease; Dizziness; Dyspnea; Elderly; Electrocardiogram; Electrophysiology (science); Epidemiologic Studies; Epidemiology; Etiology; Event; Fibrosis; Fostering; Functional disorder; Funding; Future; Gender; Gene Mutation; General Population; Genes; Genetic; Genetic Determinism; Health; Heart Diseases; Heart failure; Hospitalization; Hypertension; Incidence; Individual; Ischemia; Knowledge; Lead; Life Style; Link; Measures; Medical; Medicare; Meta-Analysis; Minority; Morbidity - disease rate; N-terminal; NT-proBNP; National Heart, Lung, and Blood Institute; Obesity; Outcome; Pacemakers; Palpitations; Pericarditis; Pharmaceutical Preparations; Physical activity; Population; Prevention strategy; Preventive; Race; Recording of previous events; Reporting; Research; Resources; Rheumatism; Risk; Risk Factors; Sampling; Sick Sinus Syndrome; Sinoatrial Block; Sinoatrial Node; Sinus; Sinus Bradycardia; Smoking; Stroke; Symptoms; Syncope; Syndrome; Tachyarrhythmias; Therapeutic; Troponin; Troponin T; United States Centers for Medicare and Medicaid Services; Woman; aged; base; cardiovascular disorder risk; cardiovascular risk factor; chronotropic; cohort; cost; effective therapy; genome-wide; genome-wide analysis; high risk; implantation; interest; men; modifiable risk; mortality; population based; prevent; prospective; racial and ethnic; socioeconomics; tool

DESCRIPTION (provided by applicant): Sick sinus syndrome (SSS) is a disorder characterized by symptomatic dysfunction of the sinoatrial node. SSS accounts for 30-50% of indications for pacemaker implantations in the US and other Western countries. Despite its burden and associated costs, no previous studies have explored the incidence and risk factors for SSS in the general population. If modifiable risk factors are identified, the possibility exists that SSS might be preventable in many individuals. Similarly, limited information exists on the impact of SSS on the overall risk of cardiovascular disease and mortality. We propose to use available data from the Atherosclerosis Risk in Communities (ARIC) Study and the Cardiovascular Health Study (CHS), two community-based prospective cohorts in the US including 21,680 men and women, whites and African-Americans, aged 45 and older at baseline, to address the following aims: (1) To calculate the age, gender and race-specific incidence of SSS in ARIC and CHS, and estimate the total annual number of SSS events occurring in the US; (2) To identify lifestyles, clinical variables and biomarkers associated with the incidence of SSS, and to develop tools that help to predict the future risk of SSS in asymptomatic individuals; (3) To evaluate the association of SSS incidence with the subsequent risk of other cardiovascular outcomes (coronary heart disease, heart failure, atrial fibrillation) and total mortality. As an exploratory aim, we will explore genetic determinants of SSS using candidate gene and genome-wide approaches. Risk factors that will be studied include, but are not limited to, socioeconomic variables, smoking, physical activity, diet, smoking, body mass index and other adiposity measures, blood pressure, diabetes, blood cholesterol, electrocardiographic parameters, and history of cardiovascular disease (coronary heart disease, heart failure, and stroke) or chronic kidney disease. Biomarkers of interest include: C-reactive protein, NT-proBNP, and troponin T. SSS incident events will be identified from hospitalization discharge codes and Medicare (from the Center for Medicare and Medicaid Services (CMS)) data. Overall, our study will include a sample of more than 20,000 individuals from a diverse racial/ethnic and geographical background followed for almost 20 years. We expect to identify more than 400 incident cases of SSS. The proposed research constitutes an efficient approach to understand the epidemiology and etiopathogenesis of a relatively common cardiac condition in the elderly, and will provide relevant data to develop preventive strategies for SSS and foster our knowledge of cardiac electrophysiology. PUBLIC HEALTH RELEVANCE: Sick sinus syndrome (SSS) accounts for 30-50% of pacemaker implantations in the US. Still, little is known about its distribution in the population, its risk factors, and its impact on cardiovascular outcomes and mortality. The proposed research will use available data from two large cohort studies to answer relevant questions about the epidemiology of SSS. Results from this study will provide a better understanding of SSS and cardiac electrophysiology, which could lead eventually to new preventive and therapeutic approaches for this and other cardiac conditions such as atrial fibrillation and cardiac conduction disturbances.

描述（由申请人提供）：病态的窦综合征（SSS）是一种疾病，其特征是窦节点的症状功能障碍。 SSS占美国和其他西方国家的起搏器植入指示的30-50％。尽管负担负担和相关成本，但以前的研究尚未探讨总人群中SSS的发病率和危险因素。如果确定了可修改的危险因素，则可能存在许多人可以预防SSS的可能性。同样，有关SSS对心血管疾病和死亡率总体风险的影响的有限信息。 We propose to use available data from the Atherosclerosis Risk in Communities (ARIC) Study and the Cardiovascular Health Study (CHS), two community-based prospective cohorts in the US including 21,680 men and women, whites and African-Americans, aged 45 and older at baseline, to address the following aims: (1) To calculate the age, gender and race-specific incidence of SSS in ARIC and CHS, and estimate the在美国发生的SSS事件的年度总数； （2）确定与SSS发生率相关的生活方式，临床变量和生物标志物，并开发有助于预测无症状个体中SSS的未来风险的工具； （3）评估SSS发病率与其他心血管结局（冠心病，心力衰竭，心房颤动）和总死亡率的风险。作为探索性目的，我们将使用候选基因和全基因组方法探索SSS的遗传决定因素。将要研究的危险因素包括但不限于社会经济变量，吸烟，体育锻炼，饮食，吸烟，体重指数和其他脂肪度量，血压，糖尿病，血液胆固醇，心电图参数以及心血管疾病的病史以及心脏病，心脏病，心脏病，心脏失败，心脏失败，心脏失败，心脏失败和疾病。感兴趣的生物标志物包括：C反应蛋白，NT-ProBNP和Troponin T. SSS事件事件将从住院排放法规和Medicare（来自Medicare and Medicaid Services中心（CMS））数据中确定。总体而言，我们的研究将包括来自种族/种族和地理背景的20,000多名个人的样本，近20年。我们希望确定400多个SSS事件案例。拟议的研究构成了一种有效的方法，可以理解老年人中相对常见的心脏病的流行病学和病原体发生，并将提供相关数据以制定SSS的预防策略并促进我们对心脏电生理学的了解。 公共卫生相关性：病态鼻窦综合征（SSS）占美国起搏器植入的30-50％。尽管如此，对其在人口中的分布，风险因素以及对心血管结局和死亡率的影响知之甚少。拟议的研究将使用来自两项大型队列研究的可用数据来回答有关SSS流行病学的相关问题。这项研究的结果将更好地了解SSS和心脏电生理学，这最终可能导致针对这种和其他心脏疾病（例如心房颤动和心脏传导障碍）的新预防和治疗方法。