Magnetic Resonance Imaging of Carotid Artery Subclincal Atherosclerosis

描述(由申请人提供)： Jarett D.Berry医学博士已获得西北大学预防医学系(初级)和心内科医学部(二级)的任命，从2008年7月起生效。这位候选人的长期目标是将心血管医学的职业生涯与在人群研究中使用磁共振成像(MRI)方法表征斑块的研究独立性结合起来。这位候选人之前在心血管疾病流行病学方面的研究经验侧重于风险估计的替代统计建模策略。新兴的成像方法，如颈动脉MRI，可以准确地量化和表征斑块负荷(即“易损斑块”)。然而，目前尚不清楚如何将斑块成像数据整合到临床决策中，因为人们对其与传统风险因素在整个生命周期内的关联知之甚少。拟议的职业发展计划包括生物医学工程、核磁共振图像采集、核磁共振图像分析和数据分析方面的高级培训，通过结构化的课程作业、研讨会和培训经验相结合。目前的建议是对现有的由NHLBI资助的研究-“芝加哥健康老龄化研究”(CHAS)的辅助研究，在该研究中，在20世纪60年代年龄在25-44岁测量的风险因素的个人将在几十年后65-79岁重新检查冠状动脉钙化、炎症和身体功能。由于这些参与者在年轻时就对风险因素进行了测量，因此在CHAS中增加颈动脉MRI测量提供了一个独特且经济高效的机会来比较年龄在25-44岁时测量的风险因素与在65-79岁时测量的颈动脉MRI斑块特征之间的关联。主要的具体目标包括：(1)确定年龄在25-44岁的低风险(LR)状态与年龄65-79岁的颈动脉粥样硬化的MRI测量的关联；(2)确定在65-79岁测量的颈动脉粥样硬化的MRI测量与冠状动脉和外周动脉床亚临床动脉粥样硬化同时测量的关联。这项研究将填补我们对LR状态长期后果知识的重大空白，这可能最终导致公共卫生和预防战略的改善。

DESCRIPTION (provided by applicant): Jarett D. Berry, MD, has received an appointment effective July, 2008 in the Department of Preventive Medicine (primary) and the Department of Medicine, Division of Cardiology (secondary) at Northwestern University. The candidate's long-term goal is to combine a career in cardiovascular medicine with research independence in the study of plaque characterization using magnetic resonance imaging (MRI) methods in population studies. The candidate's previous research experience in cardiovascular disease epidemiology has focused on alternative statistical modeling strategies for risk estimation. Emerging imaging methods such as carotid MRI can accurately quantify and characterize plaque burden (i.e. "the vulnerable plaque"). However, it remains unclear exactly how to incorporate plaque imaging data into clinical decision-making because little is known regarding its association with traditional risk factors across the lifespan. The proposed career development plan incorporates advanced training in biomedical engineering, MRI image acquisition, MRI image analysis, and data analysis through a combination of structured coursework, seminars, and training experiences. The present proposal is an ancillary study to an existing NHLBI-funded study, the "Chicago Healthy Aging Study" (CHAS) in which individuals with risk factors measured at age 25- 44 years in the 1960s will be reexamined for the presence of coronary calcium, inflammation, and physical functioning decades later at ages 65-79 years. Because risk factors were measured in these participants at a young age, the addition of carotid MRI measures to the CHAS provides a unique and cost-effective opportunity to compare the association between risk factors measured at ages 25-44 years and carotid MRI plaque characteristics at age 65-79 years. The primary specific aims include: (1) to determine the association of low-risk (LR) status at ages 25-44 years with MRI measures of carotid atherosclerosis at ages 65-79 years; (2) to determine the association of MRI measures of carotid atherosclerosis measured at ages 65-79 years with concurrent measures of subclinical atherosclerosis in the coronary and peripheral arterial beds. This research will fill critical gaps in our knowledge of the long-term consequences of LR status, which may ultimately lead to improvements in public health and preventive strategies.