Aortic Calcium: epidemiology and progression

描述（由申请人提供）：通过计算机断层扫描测量的主动脉钙，比其他亚临床（即无症状）心血管疾病（CVD）标志物更早发生，显示范围广泛，在女性中很常见。大尺寸的主动脉和相对缺乏的图像伪影的运动，使其成为理想的放射定量成像。该申请与多种族动脉粥样硬化研究（MESA）协调，MESA是一项大型前瞻性流行病学研究，旨在调查多种亚临床CVD指标和CVD风险因素。梅萨的亚临床指标包括冠状动脉钙化、颈动脉超声、心脏磁共振成像和踝/臂血压指数。广泛的CVD风险因素测量包括传统的风险因素和较新的测量，如炎症和遗传标记物。 本申请的主要长期目标是确定主动脉钙的流行病学。将对2000名随机选择的（总共6500名）梅萨参与者进行研究。需要解决的问题包括主动脉钙化进展的预测因素;主动脉钙化和主动脉钙化进展与其他亚临床CVD指标、CVD危险因素和人口统计学的相关性;以及主动脉钙化的预后意义。该项目有三个主要具体目标：1）预测作为其他亚临床CVD指标和CVD风险因素的函数的横截面主动脉钙负荷; 2）预测作为其他亚临床CVD指标和CVD风险因素的函数的主动脉钙进展; 3）预测作为选定亚临床CVD指标和CVD风险因素进展的函数的主动脉钙进展。两个次要特定目的是：1）对比男性与女性以及四个主要种族群体（白色、西班牙裔、黑人和亚洲人）的三个主要特定目的的结果; 2）提供一个数据库，用于未来评价主动脉钙化和/或主动脉钙化进展是否独立预测随后的心肌梗死、卒中和其他CVD事件。 这种应用可能对心血管健康具有重大意义。“全身扫描”包括测量主动脉钙，已成为一种流行的诊断工具。该应用程序与梅萨中可用的广泛亚临床和风险因素测量相结合，将唯一允许确定CVD风险评估中测量主动脉钙的独立和增量重要性。

DESCRIPTION (provided by applicant): Aortic calcium, measured by computed tomography, occurs earlier in life than other subclinical (that is, asymptomatic) markers of cardiovascular disease (CVD), shows a wide range, and is common in women. The large size of the aorta and relative lack of image artifact from motion make it ideal for radiographic quantitative imaging. This application is coordinated with the Multi-Ethnic Study of Atherosclerosis (MESA), a large prospective epidemiologic study investigating multiple subclinical CVD measures and CVD risk factors. Subclinical measures in MESA include coronary calcium, carotid ultrasound, cardiac magnetic resonance imaging, and the ankle/brachial blood pressure index. The extensive CVD risk factor measurements include both traditional risk factors and newer measures such as inflammatory and genetic markers. The primary long-term objective of this application is to determine the epidemiology of aortic calcium. 2000 randomly selected (from 6500 total) MESA participants will be studied. Questions to be addressed include predictors of aortic calcium progression; associations of aortic calcium and aortic calcium progression with other subclinical CVD measures, CVD risk factors, and demographics; and the prognostic significance of aortic calcium. The project has three primary specific aims: 1) to predict the cross-sectional aortic calcium burden as a function of other subclinical CVD measures and CVD risk factors; 2) to predict aortic calcium progression as a function of other subclinical CVD measures and CVD risk factors, and 3) to predict aortic calcium progression as a function of progression of selected subclinical CVD measures and CVD risk factors. The two secondary specific aims are 1) to contrast the results of the three primary specific aims for men vs. women, and for four major ethnic groups (White, Hispanic, Black, and Asian); and 2) to provide a database for future evaluation of whether aortic calcium and/or aortic calcium progression independently predict subsequent myocardial infarction, stroke, and other CVD events. This application potentially has major significance for cardiovascular health. "Total body scanning" including measurement of aortic calcium, has become a popular diagnostic tool. This application, in conjunction with the extensive subclinical and risk factor measurements available in MESA, will uniquely allow determination of the independent and incremental importance of measuring aortic calcium in CVD risk assessment.