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: 8717546
• 负责人: Tina E Brinkley
• 金额: $ 11.27万
• 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 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8717546
• 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).

职位描述（由申请人提供）：该候选人是内科老年学和老年医学科的讲师。她以前的研究重点是运动训练对老年人心血管疾病危险因素变化的影响。该K 01奖的接收将提供成像，流行病学和血管生物学/力学的培训，从而使她具备成为心血管衰老领域独立研究人员所需的技能。研究：拟议的研究将是血管僵硬度和肺水肿研究的辅助研究，这是一项前瞻性研究，旨在研究多巴酚丁胺应激诱导的主动脉僵硬度变化与老年高危患者急性肺水肿之间的相关性。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度动态变化之间的关系; 2）确定PCAT和PVAT是否可预测平均随访3.5年的心脏事件。还将检查PCAT和PVAT与结局之间相关性的潜在机制，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，其在PCAT和PVAT中表达，并且对心血管功能和胰岛素作用具有有效作用。假设PCAT和PVAT与主动脉僵硬度的动态变化呈正相关，且较高水平与未来心脏事件风险增加相关。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。该K 01奖将为候选人提供受保护的研究时间和指导培训，以学习技术和统计方法来测试这些特定目标。她在本研究开展期间获得的知识将最终为她提供MRI应用于评估干预措施的专业知识，这些干预措施旨在改变血管功能和心血管疾病风险中年龄相关变化的轨迹。环境：有一个丰富的研究和培训环境，在老龄化相关的研究在医学院的WFU。候选人的研究和职业目标的成功完成将由一个高素质的，多学科的导师和顾问团队与流行病学的专业知识指导（Drs. Kritchevsky和丁），心脏成像（Dr. Hundley），区域体脂分布（Drs. Nicklas和丁），心血管衰老（Dr. Kitzman），和生物统计学（Dr. Leng）。