Magnetic Resonance Imaging for Global Atherosclerosis Risk Assessment

 描述(由申请者提供)：本申请是由医学博士Janet wei提交的名为“磁共振成像用于全球动脉粥样硬化风险评估”的以患者为导向的研究职业发展奖的申请书，以继续她作为预防心脏病学和动脉粥样硬化磁共振成像(MRI)测量跨学科领域的翻译研究员的专业发展。心血管疾病(CVD)仍然是美国的主要死亡原因。二级预防策略减少但不能消除复发心血管事件的风险，许多患者接受治疗以减少一次事件。目前的风险预测没有针对单个患者的动脉粥样硬化负担或不良斑块特征进行个性化，目前已证明这些特征具有预后价值。目前对单个血管床中动脉粥样硬化负荷和不良斑块特征的测量比传统危险因素更能改善对CVD事件的预测，但它们的临床应用并不是为了预测复发事件的风险或监测治疗反应。已经开发出使用MRI方法评估冠状动脉、颈动脉和股动脉粥样硬化的新技术，这些方法快速、可重复、具有更高的空间分辨率，并且不需要造影剂，使得在多个血管床上评估动脉粥样硬化成为可能。由于冠状动脉血管床比颈动脉和股血管床对心脏事件具有更大的风险评估价值，魏博士假设，与目前可用的单独血管床测量方法相比，使用所有三种血管床对斑块负荷和不良斑块特征进行全球MRI测量将提高对心血管疾病风险的辨别能力，并可能有助于监测治疗反应。拟议的项目以魏博士在普通临床心脏病学和基础心血管成像方面的优势为基础，她将接受额外的培训，内容包括[1]心血管疾病预防和流行病学、[2]动脉粥样硬化斑块的核磁共振定量和表征，以及[3]用于风险预测的先进生物统计学和研究方法。她预计这次培训将给她提供工具，在临床试验中应用MRI动脉粥样硬化模型，开发个性化的心血管疾病预防和治疗策略。

 DESCRIPTION (provided by applicant): This application for a Mentored Patient-Oriented Research Career Development Award entitled "Magnetic Resonance Imaging for Global Atherosclerosis Risk Assessment" is being submitted by Janet Wei, MD, to continue her professional development as a translational researcher in the inter-disciplinary field of preventive cardiology and magnetic resonance imaging (MRI) measures of atherosclerosis. Cardiovascular disease (CVD) remains the leading cause of death in the United States. Secondary prevention strategies reduce but do not eliminate the risk of recurrent CVD events and many patients are treated to reduce one event. Current risk prediction is not personalized to an individual patient's atherosclerotic burden or adverse plaque features, which have now been shown to have prognostic value. Current measures of atherosclerosis burden and adverse plaque features in individual vascular beds improve prediction of CVD events over traditional risk factors, but their clinical application is not developed for risk prediction of recurrent evens or for therapeutic response monitoring. Novel techniques have been developed for assessing coronary, carotid, and femoral atherosclerosis using MRI methods that are rapid and reproducible, have improved spatial resolution, and do not require contrast media, making atherosclerosis assessment in multiple vascular beds feasible. Because the coronary vascular bed has greater risk assessment value for cardiac events than the carotid and femoral vascular beds, Dr. Wei hypothesizes that global MRI measures of plaque burden and adverse plaque features using all three vascular beds will improve CVD risk discrimination compared to currently available individual vascular bed measures and may be useful to monitor treatment response. The proposed project builds on Dr. Wei's strengths in general clinical cardiology and basic cardiovascular imaging, and she will receive additional training in [1] CVD prevention and epidemiology, [2] MRI quantification and characterization of atherosclerotic plaque, and [3] advanced biostatistics and research methodology for risk prediction. She anticipates that this training will give her the tools to apply MRI atherosclerosis models in clinical trials for the development of personalized CVD prevention and treatment strategies.