Magnetic Resonance Imaging of Carotid Artery Subclincal Atherosclerosis

描述（由申请人提供）： Jarett D. Berry 医学博士已于 2008 年 7 月在西北大学预防医学系（初级）和心脏病学系（次级）获得任命。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) 方法进行斑块表征研究的独立性相结合。该候选人之前在心血管疾病流行病学方面的研究经验主要集中在风险评估的替代统计建模策略上。颈动脉 MRI 等新兴成像方法可以准确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纳入临床决策，因为人们对其与整个生命周期传统风险因素的关联知之甚少。拟议的职业发展计划通过结构化课程、研讨会和培训经验的结合，纳入生物医学工程、MRI 图像采集、MRI 图像分析和数据分析方面的高级培训。目前的提案是 NHLBI 资助的现有研究“芝加哥健康老龄化研究”(CHAS) 的一项辅助研究，该研究对 1960 年代 25-44 岁时具有危险因素的个体进行重新检查，以了解几十年后 65-79 岁时冠状动脉钙化、炎症和身体机能的存在情况。由于这些参与者在年轻时就测量了危险因素，因此在 CHAS 中添加颈动脉 MRI 测量提供了一个独特且具有成本效益的机会，可以比较 25-44 岁测量的危险因素与 65-79 岁颈动脉 MRI 斑块特征之间的关联。主要具体目标包括：(1) 确定 25-44 岁低风险 (LR) 状态与 65-79 岁颈动脉粥样硬化 MRI 测量值之间的关系； (2) 确定 65-79 岁颈动脉粥样硬化 MRI 测量值与冠状动脉和外周动脉床亚临床动脉粥样硬化同步测量值之间的关联。这项研究将填补我们对 LR 状态长期后果的了解的关键空白，这可能最终导致公共卫生和预防策略的改善。

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.