Cardiac Imaging of Thoracic Fat and Aortic Stiffness in Older High Risk Patients

老年高危患者胸部脂肪和主动脉僵硬的心脏成像

• 批准号: 8526316
• 负责人: Tina E Brinkley
• 金额: $ 11.22万
• 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: 2010-09-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8526316
• 关键词: Abdomen; Address; Adipocytes; Adipose tissue; Admission activity; Aging; Ancillary Study; Aorta; Area; Atherosclerosis; Biological Markers; Biology; Biometry; Blood Vessels; Blood flow; Body fat; Cardiac; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Central obesity; Chest; Communities; Coronary; Coronary Arteriosclerosis; Data; Diabetes Mellitus; Disease; Dobutamine; Elderly; Enrollment; Environment; Epidemiologic Studies; Epidemiology; Event; Exercise; Fatty acid glycerol esters; Future; Geriatrics; Gerontology; Goals; Health Care Costs; Heart; Heart failure; Hospitalization; Hospitals; Hypertension; Image; Individual; Insulin; Insulin Resistance; Internal Medicine; Intervention; Knowledge; Learning; Lung; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Mediating; Mentored Research Scientist Development Award; Mentors; Morbidity - disease rate; Myocardial Infarction; Obesity; Obesity associated cardiovascular disease; Older Population; Outcome; Participant; Patients; Pericardial body location; Population; Prospective Studies; Pulmonary Edema; Qualifying; Randomized Controlled Trials; Research; Research Personnel; Research Training; Rest; Risk; Risk Factors; Role; Statistical Methods; Stress; Stroke; Testing; Time; Training; Vasodilation; Visceral; adipokines; adiponectin; age related; arterial stiffness; base; cardiovascular disorder risk; cardiovascular risk factor; career; clinically significant; cohort; cost effective; follow-up; glucose uptake; high risk; improved; indexing; innovation; instructor; interest; medical schools; mortality; multidisciplinary; novel; population based; prevent; public health relevance; response; skills; sound; therapy design

DESCRIPTION (provided by applicant): The candidate is an Instructor in the Section on Gerontology and Geriatric Medicine in the Department of Internal Medicine. Her previous research focused on the effects of exercise training on changes in cardiovascular disease risk factors in older persons. Receipt of this K01 award will provide training in imaging, epidemiology, and vascular biology/mechanics, thereby equipping her with the skills necessary to become an independent researcher in the field of cardiovascular aging. Research: The proposed research will be an ancillary study to the Vascular Stiffness and Pulmonary Edema Study, a prospective study examining the association between dobutamine stress-induced changes in aortic stiffness and flash pulmonary edema warranting hospital admission in older high risk patients. The major aims of the present study are to 1) quantify the relationship between pericardial and perivascular adipose tissue (PCAT, PVAT) and dynamic changes in aortic stiffness in response to dobutamine-induced stress and 2) determine whether PCAT and PVAT predict cardiac events over a mean follow-up of 3.5 years. Potential mechanisms underlying the association between PCAT and PVAT and the outcomes will also be examined, including the possibility of a local effect that is perhaps mediated by adipocyte-derived factors (i.e. adipokines). Of particular interest is adiponectin, which is expressed in both PCAT and PVAT and has potent effects on cardiovascular function and insulin action. The hypotheses are that PCAT and PVAT will be positively associated with dynamic changes in aortic stiffness and that higher levels will be associated with an increased risk of future cardiac events. We also anticipate that these relationships will be independent of traditional risk factors, as well as abdominal visceral fat, adiponectin, and insulin resistance. This K01 award will provide the candidate with protected research time and mentored training to learn the technical and statistical methods to test these specific aims. The knowledge she acquires during the conduct of this study will ultimately provide her with expertise in the application of MRI to the assessment of interventions designed to alter the trajectory of age- related changes in vascular function and cardiovascular disease risk. Environment: There is an enriched research and training environment in aging-related studies within the WFU School of Medicine. The successful completion of the candidate's research and career goals will be guided by a highly-qualified, multidisciplinary team of mentors and consultants with expertise in epidemiology (Drs. Kritchevsky and Ding), cardiac imaging (Dr. Hundley), regional body fat distribution (Drs. Nicklas and Ding), cardiovascular aging (Dr. Kitzman), and biostatistics (Dr. Leng). PUBLIC HEALTH RELEVANCE: This study will help to refine the relationship between obesity and cardiovascular disease risk by determining the importance of fat around the heart and blood vessels in relation to aortic stiffness and risk of future cardiac events. This knowledge will be useful in developing randomized controlled trials of interventions that may reduce the morbidity, mortality, and health care costs associated with cardiovascular diseases.

应聘者描述(申请人提供)：应聘者为内科老年学与老年医学部讲师。她之前的研究重点是运动训练对老年人心血管疾病风险因素变化的影响。获得K01奖将提供成像、流行病学和血管生物学/力学方面的培训，从而使她具备成为心血管衰老领域的独立研究人员所需的技能。研究：这项拟议的研究将是血管僵硬和肺水肿研究的辅助研究，该研究是一项前瞻性研究，旨在研究多巴酚丁胺应激导致的主动脉僵硬改变与老年高危患者需要入院的闪发性肺水肿之间的关系。本研究的主要目的是1)量化心包和血管周围脂肪组织(PCAT、PVAT)与多巴酚丁胺诱导的应激反应中主动脉僵硬的动态变化之间的关系；2)确定PCAT和PVAT是否可以预测平均3.5年的随访期间的心脏事件。还将研究PCAT和PVAT之间潜在的关联机制和结果，包括可能由脂肪细胞衍生因子(即脂肪因子)介导的局部效应的可能性。特别令人感兴趣的是脂联素，它在PCAT和PVAT中都有表达，对心血管功能和胰岛素作用有很强的影响。假设PCAT和PVAT将与主动脉僵硬的动态变化呈正相关，而较高的水平将与未来心脏事件的风险增加相关。我们还预计，这些关系将独立于传统的危险因素，以及腹部内脏脂肪、脂联素和胰岛素抵抗。这一K01奖项将为候选人提供受保护的研究时间和指导培训，以学习测试这些特定目标的技术和统计方法。她在进行这项研究期间获得的知识最终将为她提供应用核磁共振技术评估干预措施的专业知识，这些干预措施旨在改变与年龄相关的血管功能和心血管疾病风险变化的轨迹。环境：WFU医学院在老龄相关研究方面有一个丰富的研究和培训环境。成功完成候选人的研究和职业目标将由一支高素质的多学科导师和顾问团队指导，这些导师和顾问具有流行病学(Kritchevsky博士和Ding博士)、心脏成像(Hundley博士)、区域体脂分布(Nicklas博士和Ding博士)、心血管衰老(Kitzman博士)和生物统计学(Leng博士)的专长。 公共卫生相关性：这项研究将通过确定心脏和血管周围的脂肪与主动脉僵硬和未来心脏事件风险的关系来帮助细化肥胖和心血管疾病风险之间的关系。这些知识将有助于开发干预措施的随机对照试验，以降低与心血管疾病相关的发病率、死亡率和医疗费用。