Longitudinal Changes in Pericardial Adiposity and Subclinical Atherosclerosis

心包肥胖和亚临床动脉粥样硬化的纵向变化

• 批准号: 8451839
• 负责人: John Jeffrey Carr
• 金额: $ 33.06万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8451839
• 关键词: Abdomen; Adipose tissue; Adult; Affect; African American; Age; Ancillary Study; Atherosclerosis; Autopsy; Behavioral; Biological Markers; Body mass index; Calcified; Calcium; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Clinical; Cohort Studies; Communities; Contracts; Coronary; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Coupled; Data; Development; Disease; Dual-Energy X-Ray Absorptiometry; Echocardiography; Epidemic; Etiology; Event; Exposure to; Fatty acid glycerol esters; Funding; Future; Health; Heart; Heart Diseases; Image; Incidence; Individual; Investments; Left; Left Ventricular Mass; Lesion; Lesion by Morphology; Life; Light; Link; Literature; Measurement; Measures; Metabolic; Methods; Morbidity - disease rate; Morphology; Myocardium; Natural History; Obesity; Optical Coherence Tomography; Organ; Outcome Study; Participant; Patients; Pericardial body location; Phenotype; Play; Population; Prevention; Process; Relative (related person); Resolution; Risk; Risk Assessment; Risk Factors; Role; Scanning; Science; Stroke Volume; Structure; Sum; Techniques; Time; Ultrasonography; Ventricular End-Diastolic Volumes; Visceral; Weight; Work; X-Ray Computed Tomography; abdominal fat; acute coronary syndrome; aged; base; calcification; cardiovascular disorder risk; clinical practice; cohort; follow-up; heart disease risk; high risk; high standard; imaging modality; indexing; longitudinal analysis; middle age; millimeter; mortality; new therapeutic target; nutrition related genetics; pericardial sac; population based; premature; programs; psychosocial; public health relevance; waist circumference; young adult

DESCRIPTION (provided by applicant): The epidemic of obesity threatens recent rogress towards reducing the health burden of coronary heart disease (CHD) in the U.S. population. While much is known regarding how obesity and cardio- metabolic risk factors affect the coronary arteries and heart, much remains uncertain. In addition to the fairly rich literature on computed tomography (CT) measures of visceral adipose tissue (VAT), there is mounting evidence that pericardial adipose tissue (PAT), and the epicardial subcompartment (PATepi), is associated with coronary atherosclerosis and cardiac structure-function. CT measures of PAT, PATepi and VAT refine the adiposity phenotype to precise organ-specific measures, compared to weight and body mass index. This project is an ancillary study to NHLBI's Coronary Artery Risk Development in Young Adults (CARDIA), a population-based study that has 25 years of longitudinal data. The long-term objectives of this proposal are to reduce death and disease through a better understanding of obesity and CHD. Our Specific Aims are: 1) To define the development and natural history of coronary artery calcified (CAC) plaque burden, spotty lesion morphology, and the interrelatedness of the two processes by cardiac CT at three time points over 10 years (2000-2010) in a bi-racial community dwelling population ages 33 to 55 years. 2) To measure PAT and PATepi in the same participants at three time points and perform longitudinal analysis, adjusted for body fatness measures (BMI and waist circumference) and other risk factors, with dependent variables the development, amount, and character of CAC score and spotty plaques by CT and adverse cardiac structure and function measured by echocardiogram. 3) To measure coronary artery remodeling index (RI) in individuals aged 43-55 years with the high-resolution year 25 CT scans and determine the association between RI and PAT, PATepi, VAT (measured by main study), CAC score and spotty lesions, adjusted for body fatness measures (BMI and waist circumference) and other risk factors. Future analysis for prediction of CHD events will be possible by 2015-2020 for aims 1-3. Cardiac CT images, without contrast, will be obtained at standard and high-resolution from a single exposure to measure PAT, PATepi, CAC score, spotty morphology and RI from a 14 second additional scan to the funded abdominal CT. The latter two "high-risk" phenotypes are associated with culprit lesions of the acute coronary syndrome identified by intracoronary ultrasound or at autopsy. This proposal leverages the investment in CARDIA by adding new science related to PAT and its role in coronary atherosclerosis and cardiac structure-function. This project will link 25 years of CARDIA longitudinal data (anthropometric, biomarker, behavioral, psychosocial, nutritional, genetic, CT VAT and cardiac echocardiography) to new phenotypes. Prospectively measuring these phenotypes in 2010-11 will enable future analysis for prediction of clinical CHD events by 2015-20, further strengthening the impact.

描述（由申请人提供）：肥胖的流行威胁着最近在减轻美国人口冠心病 (CHD) 健康负担方面取得的进展。虽然人们对肥胖和心脏代谢危险因素如何影响冠状动脉和心脏了解很多，但仍有很多不确定性。除了有关内脏脂肪组织 (VAT) 的计算机断层扫描 (CT) 测量的相当丰富的文献外，越来越多的证据表明心包脂肪组织 (PAT) 和心外膜下室 (PATepi) 与冠状动脉粥样硬化和心脏结构功能相关。与体重和体重指数相比，PAT、PATepi 和 VAT 的 CT 测量将肥胖表型细化为精确的器官特异性测量。该项目是 NHLBI 年轻人冠状动脉风险发展 (CARDIA) 的一项辅助研究，这是一项基于人群的研究，拥有 25 年的纵向数据。该提案的长期目标是通过更好地了解肥胖和冠心病来减少死亡和疾病。我们的具体目标是： 1) 在年龄为 33 至 55 岁的双种族社区居住人群中，通过心脏 CT 在 10 年（2000-2010 年）三个时间点通过心脏 CT 来确定冠状动脉钙化 (CAC) 斑块负荷、点状病变形态以及这两个过程的相互关系。 2) 在三个时间点测量同一参与者的 PAT 和 PATepi，并进行纵向分析，根据身体脂肪测量值（BMI 和腰围）和其他危险因素进行调整，因变量为 CAC 评分和 CT 斑点斑块的发展、数量和特征，以及超声心动图测量的不良心脏结构和功能。 3) 通过高分辨率 25 年 CT 扫描测量 43-55 岁个体的冠状动脉重塑指数 (RI)，并确定 RI 与 PAT、PATepi、VAT（由主要研究测量）、CAC 评分和点状病变之间的关联，并根据身体脂肪测量值（BMI 和腰围）和其他危险因素进行调整。到 2015 年至 2020 年，目标 1-3 的 CHD 事件预测未来分析将成为可能。心脏 CT 图像（无对比）将通过单次曝光以标准和高分辨率获得，以通过对资助的腹部 CT 进行 14 秒额外扫描来测量 PAT、PATepi、CAC 评分、斑点形态和 RI。后两种“高风险”表型与通过冠状动脉内超声或尸检确定的急性冠状动脉综合征的罪魁祸首相关。该提案通过增加与 PAT 及其在冠状动脉粥样硬化和心脏结构功能中的作用相关的新科学来利用对 CARDIA 的投资。该项目将把 25 年的 CARDIA 纵向数据（人体测量、生物标志物、行为、社会心理、营养、遗传、CT VAT 和心脏超声心动图）与新表型联系起来。前瞻性地测量 2010-11 年的这些表型将使未来分析能够预测 2015-20 年的临床 CHD 事件，从而进一步加强影响。