The Vascular, Autonomic, and Myocardial Phenotypes in Women with Myocardial Infarction due to Spontaneous Coronary Artery Dissection

项目描述/摘要 候选人：Tweet博士的长期目标是成为一名独立的临床研究者， 女性冠状动脉疾病领域。她的短期目标是探索血管， 有自发性冠状动脉粥样硬化病史女性自主神经和微血管表型 动脉夹层（SCAD）。为了实现这些目标，Tweet博士将：1）获得专业知识 她的科学目标所需的; 2）通过课程提高她的数据分析技能， 生物统计支持; 3）发展科学领导技能和合作关系， 把这个领域向前推进。环境：马约诊所SCAD登记处是最大的 国际SCAD登记处。Tweet博士的主要导师Joyner博士和她的职业顾问 委员会有专业知识和指导素质，以指导博士. 作为一名物理学家和科学家。背景：SCAD是导致 女性非动脉粥样硬化性急性冠状动脉综合征。大多数患者没有传统的 吸烟、高脂血症或糖尿病等危险因素。相反，外周动脉 在大多数患者中观察到诸如纤维肌性发育不良的异常。SCAD是 与压力运动和怀孕有关复发性SCAD发生在10-30%的 患者具体目标：我们的目标是评估动脉结构和力学（目标1）， 神经血管功能（目标#2）和微血管功能（目标#3）。 研究设计和结果测量：这是一项前瞻性研究， 马约诊所SCAD诊所。测量将包括动脉厚度和硬度， 交感神经压力反射敏感性和交感神经兴奋性自主反应 标准化应激源和多巴酚丁胺应激的心肌灌注超声心动图。 与候选人职业目标的关系：申请中的项目将 通过促进科学管理， 领导技能，获得新的研究技术，并产生跨学科和 多机构合作联盟。因此，这是她研究生涯中合乎逻辑的下一步 进展与NHLBI使命的关系：拟议项目符合 NHLBI理解疾病潜在病理生理机制的战略愿景 以及改善对影响妇女的疾病的研究。这符合NHLBI的利益 高血压、交感神经兴奋和心血管疾病风险。其也符合 国家卫生研究院更广泛的目标是培养下一代临床研究人员。

PROJECT DESCRIPTION/ABSTRACT Candidate: Dr. Tweet’s long-term goal is to become an independent clinical investigator in the field of coronary artery disease in women. Her short-term goal is to explore the vascular, autonomic and microvascular phenotypes in women with a history of spontaneous coronary artery dissection (SCAD). To achieve these goals, Dr. Tweet will: 1) acquire the expertise required for her scientific aims; 2) improve her data analysis skills via coursework and biostatistical support; 3) develop scientific leadership skills and collaborative relationships to move this field forward. Environment: The Mayo Clinic SCAD Registry is the largest international SCAD registry. Dr. Tweet’s primary mentor, Dr. Joyner and her Career Advisory Committee have the expertise and mentorship qualities to guide Dr. Tweet’s career development as a physician-scientist. Background: SCAD is a leading cause of nonatheroembolic acute coronary syndromes in women. Most patients do not have traditional risk factors such as tobacco use, hyperlipidemia, or diabetes. Rather, peripheral arterial abnormalities such as fibromuscular dysplasia are observed in the majority of patients. SCAD is associated with stress, exercise, and pregnancy. Recurrent SCAD occurs in 10-30% of patients. Specific Aims: We will aim to assess arterial structure and mechanics (Aim #1), neurovascular function (Aim #2), and microvascular function (Aim #3) in women with SCAD. Study Design & Outcome Measures: This is a prospective study of women evaluated in the Mayo Clinic SCAD Clinic. Measurements will include arterial thickness and stiffness, sympathetic baroreflex sensitivity and autonomic responses to sympathoexcitatory to standardized stressors, and myocardial perfusion echocardiography with dobutamine stress. Relationship to Career Goals of the Candidate: The projects in the application will be instrumental for the candidate’s career development by facilitating: scientific management and leadership skills, acquisition of new research techniques, and generating interdisciplinary and multi-institutional collaborative alliances. Thus it is the next logical step in her research career progression. Relationship to the NHLBI Mission: The proposed project is consistent with the NHLBI strategic vision for understanding underlying pathophysiological mechanisms of disease and for improving study of diseases affecting women. It is consistent with the NHLBI’s interest in hypertension, sympathoexcitation and cardiovascular disease risk. It is also consistent with broader NIH goals related to training the next generation of clinical investigators.