Atrial Fibrillation in MESA and JHS

MESA 和 JHS 中的心房颤动

• 批准号: 8747820
• 负责人: SUSAN R HECKBERT
• 金额: $ 9.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8747820
• 关键词: Address; Affect; African; Age; American; Ancillary Study; Atherosclerosis; Atrial Fibrillation; Blood; Body Weight; Cardiac; Cardiac Myocytes; Cardiovascular Diseases; Cardiovascular system; Cells; Cohort Analysis; Cohort Studies; Cytosol; Data; Databases; Deposition; Development; Diabetes Mellitus; Disease; Epidemiology; Ethnic Origin; Ethnic group; Event; Fatty acid glycerol esters; Fostering; Functional disorder; Funding; Future; Health; Health Priorities; Heart; Heart Atrium; Heart failure; Height; Hispanics; Hypertension; Individual; Inflammatory; Inpatients; Intervention; Jackson Heart Study; Joints; Knowledge; Left; Left Ventricular Mass; Left atrial structure; Lipids; Magnetic Resonance Imaging; Manuscripts; Measurement; Measures; Medicare; Medicare claim; Mentorship; Methods; Modeling; Myocardial Infarction; National Heart, Lung, and Blood Institute; Obesity; Outcome; Outpatients; Participant; Pathogenesis; Pericardial body location; Personal Communication; Pharmaceutical Preparations; Population; Population Heterogeneity; Prevention; Principal Investigator; Productivity; Public Health; Race; Research; Research Personnel; Risk Factors; Role; Staging; Strategic Planning; Stroke; Testing; Time; Visit; Weight; Work; X-Ray Computed Tomography; base; cardiovascular risk factor; career; chemokine; cohort; cytokine; design; experience; follow-up; graduate student; heart rhythm; high risk; imaging modality; innovation; lipid metabolism; novel; pericardial sac; population based; prevent; public health relevance; surveillance data; working group

DESCRIPTION (provided by applicant): The Multi-Ethnic Study of Atherosclerosis (MESA) and the Jackson Heart Study (JHS) are both NHLBI-funded cohort studies that began recruitment in 2000 and were designed to investigate the pathogenesis of atherosclerosis in Americans of diverse races/ethnicities by providing accurate measurement of cardiovascular disease, its risk factors, and its outcomes. To enhance scientific productivity from these important studies, we propose to establish a joint MESA-JHS Atrial Fibrillation (AF) Working Group to foster research that brings together exam and events surveillance data with Medicare claims data. As MESA and JHS participants reach their late 60s and 70s, AF is becoming an important health problem. Events ascertainment in both studies already includes myocardial infarction, stroke, and heart failure, but AF ascertainment is underdeveloped. Based on our experience with identifying AF in the Cardiovascular Health Study, we will work with the MESA and JHS Coordinating Centers to prepare AF events files based on data from the cohort exams, events surveillance, and inpatient and outpatient Medicare claims data. The AF events files will be incorporated into the MESA and JHS databases, adding a critically important cardiovascular outcome. We propose specific aims related to AF that are focused and innovative, and for which existing and new data from MESA and JHS are poised to make novel contributions. These analyses will be undertaken in our AF Working Group by early stage investigators with mentorship from experienced investigators. First, we hypothesize that larger pericardial fat depots are associated with larger left atrial volume and with greater longitudinal left atrial enlargement. Second, we hypothesize that larger pericardial fat depots are associated with incident atrial fibrillation. Both analyses will be adjusted for obesity, hypertension, and other cardiovascular risk factors. If our hypotheses are correct, the results will motivate future studie of interventions or medications that affect lipid levels, lipid metabolism, weight, or blood glucos, and that may also alter pericardial fat deposition, potentially preventing progressive atrial remodeling and AF. The analyses of pericardial fat, longitudinal left atrial enlargement, and AF will serve as a springboard for additional analyses and ancillary studies related to AF from our Working Group. Our work incorporating Medicare claims data to identify AF events will also serve as a model for analyses of other health outcomes that can be readily identified using Medicare claims data. The Principal Investigator is an internationally recognized expert in the epidemiology of AF, with a track record of work using Medicare claims data in NHLBI cohorts, high productivity, and mentorship of graduate students and early stage investigators.

描述（由申请人提供）：动脉粥样硬化的多种族研究（MESA）和杰克逊心脏研究（JHS）都是nhlbi资助的队列研究，于2000年开始招募，旨在通过提供心血管疾病，其危险因素和结果的准确测量来研究不同种族/民族的美国人动脉粥样硬化的发病机制。为了提高这些重要研究的科学生产力，我们建议建立一个联合MESA-JHS房颤（AF）工作组，以促进将检查和事件监测数据与医疗保险索赔数据结合起来的研究。随着MESA和JHS的参与者达到60多岁和70多岁，房颤正在成为一个重要的健康问题。在这两项研究中，事件的确定已经包括心肌梗死、中风和心力衰竭，但房颤的确定还不发达。基于我们在心血管健康研究中识别房颤的经验，我们将与MESA和JHS协调中心合作，根据队列检查、事件监测以及住院和门诊医疗保险索赔数据准备房颤事件文件。房颤事件文件将被纳入MESA和JHS数据库，增加一个至关重要的心血管结局。我们提出了与AF相关的具体目标，这些目标是重点和创新的，MESA和JHS的现有和新数据将为此做出新的贡献。这些分析将在我们的AF工作组中由经验丰富的研究人员指导的早期研究人员进行。首先，我们假设较大的心包脂肪库与较大的左心房容积和较大的左心房纵向扩大有关。其次，我们假设较大的心包脂肪库与心房颤动的发生有关。两种分析都将根据肥胖、高血压和其他心血管危险因素进行调整。如果我们的假设是正确的，结果将激励未来研究影响脂质水平、脂质代谢、体重或血糖的干预措施或药物，这也可能改变心包脂肪沉积，潜在地预防进行性心房重构和房颤。心包脂肪、纵向左心房扩大和房颤的分析将作为我们工作组与房颤相关的其他分析和辅助研究的跳板。我们结合医疗保险索赔数据来识别房颤事件的工作也将作为分析其他健康结果的模型，这些结果可以很容易地使用医疗保险索赔数据来识别。首席研究员是国际公认的房颤流行病学专家，具有在NHLBI队列中使用医疗保险索赔数据的工作记录，高生产力，并指导研究生和早期研究人员。