Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and Phenomics
从危险因素到早期心力衰竭的转变:患病率、发病机制和表型组学
基本信息
- 批准号:9313715
- 负责人:
- 金额:$ 133.87万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2015
- 资助国家:美国
- 起止时间:2015-08-01 至 2019-06-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAdultAffectAgeAir PollutionAncillary StudyAnthropometryBig DataBiological MarkersBlood PressureBlood VesselsCardiacCardiac OutputCardiopulmonaryCardiovascular AbnormalitiesChronic Kidney FailureClinicalClinical TrialsCodeCommunitiesCoronaryCoronary ArteriosclerosisCouplingDataDevelopmentDiabetes MellitusDietDyspneaEFRACEarly DiagnosisEchocardiographyElderlyElectrocardiogramEpidemiologyEthnic OriginExercise stress testFatigueFunctional disorderFutureGalectin 3GenderGeneral PopulationGoalsHealthHeartHeart AtriumHeart failureHospitalizationHypertensionICD-9ImageIncidenceIndividualLaboratoriesLeadLeftMachine LearningMagnetic Resonance ImagingMeasuresMechanicsMediatingMethodsMulti-Ethnic Study of AtherosclerosisMyocardialMyocardial InfarctionObesityOutcomeOutpatientsParticipantPathogenesisPatientsPhenotypePhysical activityPhysiologicalPopulationPopulation StudyPrevalencePreventionPrevention strategyPublic HealthRaceRecruitment ActivityRenal functionRestRiskRisk FactorsSamplingSpirometryStandardizationStressStructureSurveysSymptomsSyndromeTechniquesTestingTimeTissuesUltrasonographyValidationVentricularWalkingWeightagedarterial stiffnessarterial tonometrybasebrachial arteryclinical Diagnosiscohortdesignendothelial dysfunctionepidemiology studyethnic diversityexercise intolerancefasting glucosefitnessfunctional statushigh riskindexinglongitudinal analysisnovelnovel markerphenomicspopulation basedpressurepublic health relevancescreeningstatisticstrend
项目摘要
DESCRIPTION (provided by applicant): Heart failure (HF) is a major public health problem: it affects >6 million people in the U.S., it is the #1 cause of hospitalization and readmission in older adults, and 5-year survival after HF hospitalization is a dismal 35%, regardless of underlying ejection fraction (EF). These statistics highlight the urgent need for prevention of HF and better understanding of how and why HF develops in high-risk individuals. However, a critical limitation of prior population-based studies is the ascertainment of incident HF based on hospitalizations for HF and/or signs of overt volume overload. Many older individuals may suffer from early HF: breathlessness, fatigue, and exercise intolerance (without overt volume overload) due to underlying cardiac structure/function abnormalities, typically with a preserved EF (i.e. early HFpEF). Thus, the current epidemiology of HF is most likely missing a major form of prevalent HF. In this ancillary study of the Multi-Ethnic Study of Atherosclerosis (MESA, Year-15 Exam, n=3500), we will define early HF in a contemporary, multi-ethnic, elderly cohort; we will utilize cutting- edge indices of cardiac mechanics and ventricular-arterial interactions, including
Lagrangian strain and time- varying pressure-stress analyses; and we will perform novel phenomics analyses to better characterize the interplay of risk factors and cardiac structure/function abnormalities (i.e., multi-dimensional phenotypic signatures) as they relate to early and overt HF. The aims of our study are to: (1) determine the prevalence of early HF using a combination of validated symptom surveys, 6-minute walk test, NTproBNP, and echocardiography, with validation using cardiopulmonary exercise testing (CPEX); (2) better understand the pathophysiology of early HF, particularly HFpEF; and (3) delineate the key phenotypic signatures associated with early and overt HF. The proposed exam will include anthropometry, blood pressure, symptom surveys, functional status (6-minute walk test), physical activity, laboratory measures (NTproBNP, fasting glucose, renal function), and comprehensive echocardiography (with tissue Doppler and speckle-tracking at rest and during physiologic maneuvers) in all participants. In sub-samples we will also measure arterial tonometry, novel biomarkers, and fitness (CPEX). We will utilize the wealth of data collected during the 5 prior MESA exams to perform longitudinal analyses (including latent class trajectory and statistical learning analyses) to determine the extent to which risk factors are associated with early HF, particularly early HFpEF. By the end of our 4-year study, we will accomplish the following key goals, each of which will have a lasting impact on the field of HF: (1) we will establish the prevalence of early HF in the community; (2) we will have a standardized method for the screening/diagnosis of early HFpEF, validated by CPEX, and readily applicable to the clinical setting; (3) we will define novel mechanisms by which risk factors, alone and in combination, relate to abnormalities in cardiac mechanics and ventricular-arterial coupling in the general population; and (4) we will have defined phenotypic signatures of HF development that will inform future clinical trials for HF prevention and treatment.
描述(由申请人提供):心力衰竭(HF)是一个主要的公共卫生问题:它影响美国> 600万人,它是老年人住院和再入院的首要原因,HF住院后的5年生存率只有令人沮丧的35%,与基础射血分数(EF)无关。这些统计数据强调了预防HF的迫切需要,以及更好地了解HF在高危人群中发展的方式和原因。然而,先前基于人群的研究的一个关键限制是基于HF住院和/或明显容量超负荷体征确定HF事件。许多老年人可能患有早期HF:呼吸困难、疲劳和运动不耐受(无明显的容量超负荷),这是由于潜在的心脏结构/功能异常,通常具有保留的EF(即早期HFpEF)。因此,目前HF的流行病学很可能缺少一种主要的流行HF。在这项动脉粥样硬化多种族研究(梅萨,15岁考试,n=3500)的辅助研究中,我们将在当代、多种族、老年队列中定义早期HF;我们将利用心脏力学和心室-动脉相互作用的尖端指标,包括
拉格朗日应变和时变压力-应力分析;我们将进行新的表型组学分析,以更好地表征风险因素和心脏结构/功能异常的相互作用(即,多维表型标记),因为它们与早期和明显的HF有关。我们研究的目的是:(1)使用经验证的症状调查、6分钟步行试验、NTproBNP和超声心动图的组合,并使用心肺运动试验(CPEX)进行验证,确定早期HF的患病率;(2)更好地了解早期HF的病理生理学,特别是HFpEF;(3)描述与早期和显性HF相关的关键表型特征。拟定的检查将包括所有受试者的人体测量、血压、症状调查、功能状态(6分钟步行试验)、体力活动、实验室测量(NTproBNP、空腹血糖、肾功能)和综合超声心动图(静息和生理活动期间的组织多普勒和斑点追踪)。在子样本中,我们还将测量动脉张力、新型生物标志物和健身(CPEX)。我们将利用之前5次梅萨检查期间收集的大量数据进行纵向分析(包括潜在类别轨迹和统计学习分析),以确定风险因素与早期HF,特别是早期HFpEF相关的程度。在我们4年的研究结束时,我们将实现以下关键目标,每一个目标都将对HF领域产生持久的影响:(1)我们将确定社区中早期HF的患病率;(2)我们将有一个标准化的方法来筛查/诊断早期HFpEF,该方法经CPEX验证,并易于应用于临床环境;(3)我们将确定新的机制,通过这些机制,风险因素单独或联合与普通人群中心脏力学和心室-动脉耦合异常相关;(4)我们将确定HF发展的表型特征,这将为未来的HF预防和治疗临床试验提供信息。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
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Alain Gerald Bertoni其他文献
Alain Gerald Bertoni的其他文献
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{{ truncateString('Alain Gerald Bertoni', 18)}}的其他基金
Transition from Risk Factors to Early HF: Prevalence, Pathogenesis, and Phenomics
从危险因素到早期心力衰竭的转变:患病率、发病机制和表型组学
- 批准号:
9115219 - 财政年份:2015
- 资助金额:
$ 133.87万 - 项目类别:
Training in Health Disparity Research for a Diverse Neuroscience Workforce
为多元化的神经科学劳动力提供健康差异研究培训
- 批准号:
9321076 - 财政年份:2014
- 资助金额:
$ 133.87万 - 项目类别:
Training in Health Disparity Research for a Diverse Neuroscience Workforce
为多元化的神经科学劳动力提供健康差异研究培训
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9125880 - 财政年份:2014
- 资助金额:
$ 133.87万 - 项目类别:
Targeted Analyses of Jackson Heart Study Data
杰克逊心脏研究数据的针对性分析
- 批准号:
9081240 - 财政年份:2013
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Targeted Analyses of Jackson Heart Study Data
杰克逊心脏研究数据的针对性分析
- 批准号:
8441279 - 财政年份:2013
- 资助金额:
$ 133.87万 - 项目类别:
Targeted Analyses of Jackson Heart Study Data
杰克逊心脏研究数据的针对性分析
- 批准号:
8862525 - 财政年份:2013
- 资助金额:
$ 133.87万 - 项目类别:
Targeted Analyses of Jackson Heart Study Data
杰克逊心脏研究数据的针对性分析
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8701389 - 财政年份:2013
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