Epidemiology of Cardiac Structure and Function in African Caribbeans: The Tobago Heart Study

项目总结 心脏结构和功能异常，如左室肥厚和射血减少 分数(EF)与心力衰竭(HF)和其他心血管疾病发病率的增加有关 死亡率。超声心动图可对心脏的多个方面进行深入和低成本的评估 结构和功能。临床和流行病学研究都表明，非裔美国人 与白人相比，患高血压相关心脏异常的风险更高；然而，还没有 评估非洲加勒比人心脏结构和功能的基于人群的研究。风险因素 心脏功能障碍，如高血压和肥胖症，在非洲加勒比人中比非洲人更常见 这表明非洲加勒比人的心脏功能障碍可能比非洲人更严重。 美国人。在过去的20年里，我们一直在研究非洲加勒比的人口队列 来自多巴哥的男性和女性，我们有大量的病史，血压， 亚临床心血管测量、肥胖分布和生物制品。我们注意到一个异常高的 多巴哥男性和女性高血压失控和血压升高的比率，使他们处于 有进一步心血管疾病并存的高风险。我们有强有力的证据表明，这些参与者有很高的 非动脉粥样硬化性血管疾病；然而，到目前为止，我们还没有评估心肌健康， 这是将他们与非裔美国人或美国白人流行病队列进行比较的主要限制。 因此，我们建议通过进行超声心动图来扩大我们在多巴哥的心血管研究。 来自多巴哥男子研究和多巴哥妇女研究的50岁及以上参与者的检查(N=500 每项共1000项：多巴哥心脏研究[THS])，以描述负担并确定风险因素 非洲加勒比海人的心脏功能障碍和结构异常。具体地说，我们的目标是1)描述 并描述了THS的心脏结构和功能；2)利用多巴哥现有的丰富数据 男性和女性的研究，以确定心脏结构和功能的传统和独特相关性 非洲加勒比人，包括人口统计、病史、行为/生活方式、肥胖症 分布和亚临床心血管疾病；3)全面检测循环心脏 识别心脏生物学哪些方面与心脏结构和心脏结构最相关的生物标志物 非洲加勒比海地区的功能措施。完成这些具体目标将提供第一个评估 非洲加勒比男性和女性心脏结构和功能的变化，增加了现有的心血管疾病 多巴哥研究中的评估，并允许未来与美国的心血管疾病队列进行比较，包括 非裔美国人。重要的是，这将对相关的潜在生物过程产生独特的见解 在多巴哥的心脏结构和功能，这可以在未来的努力中加以利用，以改进预测， 在这些高危人群中预防和治疗心脏病。

PROJECT SUMMARY Abnormalities in cardiac structure and function, such as left ventricular hypertrophy (LVH) and reduced ejection fraction (EF), are associated with increased risk of heart failure (HF) and other cardiovascular morbidity and mortality. Echocardiography provides an in-depth and low-cost assessment of multiple aspects of cardiac structure and function. Both clinical and epidemiologic studies have demonstrated that African Americans are at higher risk for hypertensive related cardiac abnormalities than Whites; however, there have been no population-based studies to assess cardiac structure and function in African Caribbeans. Risk factors for cardiac dysfunction, such as hypertension and obesity, are more common in African Caribbeans than African Americans, suggesting that African Caribbeans may have even greater cardiac dysfunction than African Americans. Over the past 20 years, we have been studying population-based cohorts of African Caribbean men and women from Tobago in whom we have extensive measures of medical history, blood pressure, subclinical cardiovascular measures, adiposity distribution, and biospecimens. We noted an exceptionally high rate of uncontrolled hypertension and elevated blood pressure in Tobago men and women, which puts them at high-risk for further CVD comorbidities. We have strong evidence that these participants have a high burden of non-atherosclerotic vascular disease; however, to this point, we have not assessed cardiac muscle health, which is a major limitation in comparing them to African American or White U.S. epidemiologic cohorts. Therefore, we propose to expand our cardiovascular research in Tobago by performing an echocardiography exam in participants aged 50 and older from the Tobago Men’s Study and the Tobago Women’s Study (N=500 each, 1000 total: The Tobago Heart Study [THS]), in order to describe the burden of and identify risk factors for cardiac dysfunction and structural abnormalities in African Caribbeans. Specifically, we aim to 1) characterize and describe the cardiac structure and function of the THS; 2) use the wealth of existing data in the Tobago Men and Women’s Studies to identify traditional and unique correlates of cardiac structure and function in African Caribbeans, including measures of demography, medical history, behaviors/lifestyle, adiposity distribution, and subclinical cardiovascular disease; and 3) comprehensively assay circulating cardiac biomarkers to identify which facets of cardiac biology are most strongly associated with cardiac structure and function measures in African Caribbeans. Completion of these Specific Aims will provide the first assessment of cardiac structure and function in African Caribbean men and women, add to the existing cardiovascular assessments in the Tobago studies, and allow for future comparison to U.S.-based CVD cohorts that include African Americans. Importantly, this will yield unique insight into the underlying biologic process(es) associated with cardiac structure and function in Tobago, which can be harnessed in future efforts to improve prediction, prevention, and treatment of cardiac disease in these high-risk individuals.