PULMONARY CONGESTION AND VASCULAR STIFFNESS (PREDICT)

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 突发性闪光性肺水肿(PE)是高血压、糖尿病和冠心病患者共同发病的一种重要疾病。我们将研究那些PE的高危人群，但原因尚未确定。测试后，我们将跟踪我们的参与者一段时间，以确定发生闪光PE需要住院的测试后结果。我们的设计将使我们能够确定在控制了促进PE的其他因素(例如，年龄、左室肥厚或主动脉壁增厚)后，多巴酚丁胺期间主动脉僵硬的变化是否独立地预测闪发性PE。此外，我们的研究设计将使我们能够在控制了多巴酚丁胺对左每搏量储备(左每搏量的压力/静息比)的影响后，确定多巴酚丁胺静脉注射期间主动脉僵硬的变化是否是闪光PE的独立预测因子。我们的结果将具有重要意义，因为我们将确定影响主动脉僵硬的因素和左心功能之间的关系，以及未来需要住院的闪光PE的发生。有了这些理解，我们将获得对闪光PE病理生理学的机械性见解，这将有助于开发干预措施来预防与这种疾病相关的发病率和死亡率。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Sudden onset flash pulmonary edema (PE) is a significant co-morbidity of patients with underlying hypertension, diabetes, and coronary artery disease. We will study those at high risk for PE which an identifiable cause has not been established. After testing, we will follow our participants over time to ascertain the post-testing outcome of the occurrence of flash PE warranting hospitalization. Our design will allow us to determine if change in aortic stiffness during dobutamine independently predicts flash PE after controlling for other factors that promote PE (e.g., age, LV hypertrophy, or increased aortic wall thickening). In addition, our study design will allow us to determine if change in aortic stiffness during intravenous dobutamine is an independent predictor of flash PE after controlling for its effect on LV stroke volume reserve (stress/rest ratio of LV stroke volume). Our results will be significant in that we will define the relationship between factors affecting aortic stiffness and LV performance, and the future occurrence of flash PE warranting hospitalization. With this understanding, we will gain mechanistic insight into the pathophysiology of flash PE that will be useful for developing interventions to prevent the morbidity and mortality associated with this disorder.