Environmental Exposures and the Development of Subclinical and Clinical Vascular and Myocardial Disease

环境暴露与亚临床和临床血管和心肌疾病的发展

• 批准号: 10622466
• 负责人: Kabayam M Venkat Narayan
• 金额: $ 10.53万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10622466
• 关键词: Accounting; Address; Adult; Air; Air Pollution; Area; Arteries; Asia; Atherosclerosis; Biological; Biological Markers; Blood Glucose; Body Weight; Calcium; Cardiomyopathies; Cardiovascular Diseases; Carotid Artery Plaques; Cessation of life; Chronic Disease; Cities; Clinical; Complex; Cross-Sectional Studies; Data; Data Analyses; Development; Disease; Echocardiography; Environmental Exposure; Environmental Risk Factor; Equipment and supply inventories; Event; Functional disorder; Funding; Health; Health Policy; Heart failure; Hybrids; Hypertension; Immune; Incidence; Income; India; Inflammation; Investigation; Knowledge; Lead; Left Ventricular Dysfunction; Link; Long-Term Effects; Maps; Measurement; Measures; Mediating; Meteorology; Methods; Myocardial Infarction; Myocardial Ischemia; National Heart, Lung, and Blood Institute; Natural History; Nitrogen Oxides; Ozone; Participant; Particulate Matter; Pathogenesis; Pathway interactions; Persons; Phenotype; Pollution; Population; Population Heterogeneity; Prevention; Production; Program Research Project Grants; Proteins; Resolution; Risk Factors; Risk Reduction; Role; Sampling; Social Environment; South Asian; Stress; Stroke; Techniques; Thick; Time; Uncertainty; United States National Institutes of Health; Vascular Diseases; advanced analytics; aged; ambient air pollution; arterial stiffness; blood pressure elevation; built environment; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular effects; carotid intima-media thickness; cohort; coronary artery calcium; data management; density; disease phenotype; fine particles; follow-up; global health; high risk; improved; individualized prevention; land use; metropolitan; mortality; multiple omics; population based; predictive modeling; prospective; protein biomarkers; recruit; risk prediction; social; sociodemographics; spatiotemporal; statistical and machine learning; stem

PROJECT SUMMARY / ABSTRACT: Project 2 Environmental factors (i.e., ambient air pollution) are ubiquitous and potential causative factors in cardiovascular disease (CVD). Our preliminary studies using data from the NIH-funded GeoHealth Hub and the NHLBI-funded Center for cArdiometabolic Risk Reduction in South Asia Cohort (CARRS), indicate a strong temporal association for short- and long-term effects of ambient particulate matter (PM2.5)) exposure and elevated blood pressure and glycemic measures. Motivated by these findings, in Project 2 of Precision- CARRS, we will investigate the longitudinal association between PM2.5 and CVD subclinical and clinical CVD phenotypes (provided by the CVD Phenotyping Core). For atherosclerotic (ASCVD) and heart failure (HF) pathways. Precision-CARRS, will follow 21,864 socio-demographically diverse South Asians aged ≥20 years, representative of Delhi and Chennai, two cities with high levels of, and substantial spatio-temporal variability in, ambient air pollution. The cohort will be followed for up to 15 years, accruing 176,536 person-years and >1000 incident ASCVD (MI, stroke, CVD death) events and nearly 940 HF Stage C/D cases. PM2.5 will be assessed through a hybrid predictive model combining statistical and machine learning techniques using data from satellites, land use maps, meteorology, and emissions inventories. Our aims are: To assess the relationship between PM2.5 and: (Aim 1) Functional subclinical vascular and myocardial disease (arterial stiffness, and left ventricular dysfunction measured as either systolic and/or diastolic dysfunction using echocardiography); (Aim 2) Structural subclinical disease (artery calcium; carotid intimal media thickness, carotid plaque); (Aim 3) Clinical CVD events (i) ASCVD: incident nonfatal myocardial infarction, stroke, and CVD Death, (ii) HF: Stage C/D cases). In Aim 4, we will explore whether the pathophysiologic pathway-specific proteins measured in Project 1 (i.e., inflammation, immune dysregulation, myocardial ischemia and stress) modify the associations between PM2.5 and clinical ASCVD and HF. We will also contribute data to Project 3 to further examine the causal link between PM2.5 and CVD phenotypes using untargeted multi-omics, and Project 4 to separate social from environment influences in the production of CVD risk. We will contribute to the understanding of the connection between one of the leading adverse environmental exposures (i.e., air pollution) and CVD, to improving precision of risk prediction by accounting for environmental factors to advance precision CVD prevention, and generate data to facilitate global health policy to address air pollution.

项目摘要/摘要：项目二