Patterns of Cardiopulmonary health across the life course

整个生命过程中心肺健康的模式

• 批准号: 10634635
• 负责人: Sadiya Sana Khan
• 金额: $ 67.79万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10634635
• 关键词: Adult; Affect; Age; Age of Onset; Air Pollution; Ancillary Study; Biological Assay; Biological Markers; Biological Process; Black race; Cardiac; Cardiac health; Cardiopulmonary; Cardiovascular system; Cause of Death; Chronic lung disease; Clinical; Coronary Artery Risk Development in Young Adults Study; Data; Detection; Disease; EFRAC; Echocardiography; Elderly; Epidemiology; Event; Evolution; Four-dimensional; Functional disorder; Goals; Health; Health Transition; Heart; Heart Diseases; Heart failure; Image; Impairment; Individual; Inflammation; Inflammatory; Intervention; Joints; Left; Left ventricular structure; Life; Life Cycle Stages; Link; Lung; Lung diseases; Magnetic Resonance Imaging; Measures; Mechanics; Mediating; Mediator; Morbidity - disease rate; Multimodal Imaging; National Heart, Lung, and Blood Institute; Outcome Study; Participant; Pathway interactions; Pattern; Phenotype; Predisposition; Prevention; Prevention strategy; Proteomics; Public Health; Pulmonary Emphysema; Pulmonary Heart Disease; Pulmonary Hypertension; Race; Research; Respiratory Tract Infections; Risk; Risk Factors; Risk Marker; Scanning; Sex Differences; Spirometry; Strategic vision; Structure; Symptoms; Systems Biology; Testing; Time; Tobacco; Tobacco use; United States; Ventricular; Ventricular End-Diastolic Volumes; Viral Respiratory Tract Infection; Work; X-Ray Computed Tomography; advanced disease; blood-based biomarker; cardiac magnetic resonance imaging; clinically relevant; comorbidity; critical period; design; disorder prevention; health care service utilization; hemodynamics; imaging study; lung health; lung injury; middle age; mortality; multidisciplinary; novel; phenotypic data; pulmonary function; resilience; risk sharing; screening; theories; tobacco exposure; young adult

ABSTRACT Chronic lung disease and heart failure (HF) are highly prevalent, commonly co-occur, and are associated with significant morbidity and mortality. Work from our group and others has demonstrated an independent relationship between chronic lung disease and incident HF that may be driven in part by inflammation. We have also documented that even in the absence of symptomatic lung disease, impaired lung function defined by spirometry is associated with adverse cardiac remodeling on echocardiography and incident HF events. While symptomatic lung disease and HF often occur in the elderly, many younger adults have relatively asymptomatic impairment in lung health and cardiac structure and function. These subclinical cardiopulmonary abnormalities develop during the key modifiable period from young adulthood to midlife. However, data are sparse on the timing and associated mechanisms of the transition from health to disease spanning young adulthood to midlife, and related race-sex differences. Without identifying these unique patterns of change, it will not be possible to screen for subclinical changes and employ prevention strategies prior to irreversible damage in the lung and heart. This requires upstream identification at the earliest detectable change. While spirometry is the gold standard for lung disease detection, it is a relatively crude and insensitive measure of impaired lung health. In contrast, lung injury (quantified using a novel local histogram analysis developed and validated by our group) from computed tomography (CT) scans is a more sensitive and earlier indicator of impaired lung health (e.g. due to tobacco, air pollution, and respiratory viral infection). Therefore, we now propose to take advantage of the Coronary Artery Risk Development in Young Adults (CARDIA) study’s unique platform to study the temporal relationship of and mechanisms underlying the transition from lung and heart health to disease. To-date, our group has investigated the predictors and consequences of impaired lung health and HF, separately, in CARDIA. In this project, we will build upon our prior work by analyzing CT scans to determine the concurrent evolution of lung injury and adverse cardiac remodeling and identify mechanisms by assaying a multitude of blood-based biomarkers (using a multiplexed array) and performing 4-dimensional flow cardiovascular magnetic resonance imaging (cMRI). We will test the hypothesis that detailed imaging and blood-based markers can inform clinically relevant endotypes reflecting dynamic changes in lung injury and adverse cardiac remodeling during a key vulnerable period of life through the following specific aims: (1) Determine the longitudinal association between lung injury and left ventricular end-diastolic volume (LVEDV); (2) Determine the risk of subclinical and clinical HF among joint lung injury and LVEDV trajectory groups; and (3) Determine the hemodynamic mediators of the association between lung injury and adverse cardiac remodeling. This study will investigate factors associated with transitions from cardiopulmonary health to disease and associated mechanisms, and in doing so, will identify screening strategies and contribute novel pathways for targeted disease interception of lung and heart disease.

摘要

项目成果

The 2017 American College of Cardiology/American Heart Association Hypertension Guideline and Blood Pressure in Older Adults.

2017 年美国心脏病学会/美国心脏协会高血压指南和老年人血压。

• DOI: 10.1016/j.amepre.2023.04.011
• 发表时间: 2023
• 期刊: American journal of preventive medicine
• 影响因子: 5.5
• 作者: Wang,MichaelC;Petito,LuciaC;Pool,LindsayR;Foti,Kathryn;Juraschek,StephenP;McEvoy,JohnW;Nambi,Vijay;Carnethon,MercedesR;Michos,ErinD;Khan,SadiyaS
• 通讯作者: Khan,SadiyaS

Moving the Paradigm Forward for Prediction and Risk-Based Primary Prevention of Heart Failure in Special Populations.

推动特殊人群心力衰竭预测和基于风险的一级预防的范例。

• DOI: 10.1007/s11883-022-01009-7
• 发表时间: 2022
• 期刊: Current atherosclerosis reports
• 影响因子: 5.8
• 作者: Everitt,IanK;Trinh,KatherineV;Underberg,DanielL;Beach,Lauren;Khan,SadiyaS
• 通讯作者: Khan,SadiyaS

New strategies and therapies for the prevention of heart failure in high-risk patients.

• DOI: 10.1002/clc.23839
• 发表时间: 2022-06
• 期刊: Clinical cardiology
• 影响因子: 2.7

Rural-Urban Trends for Aortic Stenosis Mortality in the United States, 2008-2019.

2008-2019 年美国主动脉瓣狭窄死亡率的城乡趋势。

• DOI: 10.1016/j.jacadv.2023.100617
• 发表时间: 2023
• 期刊: JACC. Advances
• 作者: Hughes,ZacharyH;Hammond,MichaelM;Lewis-Thames,Marquita;Sweis,Ranya;Shah,NilayS;Khan,SadiyaS
• 通讯作者: Khan,SadiyaS

Hypertension-Related Cardiovascular Mortality in Asian American Subgroups.

亚裔美国人亚群体中与高血压相关的心血管死亡率。

• DOI: 10.1016/j.amepre.2023.01.003
• 发表时间: 2023
• 期刊: American journal of preventive medicine
• 影响因子: 5.5
• 作者: Shah,NilayS;Shimbo,Daichi;Muntner,Paul;Huffman,MarkD;Kandula,NamrathaR;Mefford,MatthewT;Lloyd-Jones,DonaldM;Khan,SadiyaS
• 通讯作者: Khan,SadiyaS