Progression of sub-clinical Atherosclerosis

描述(由申请人提供)：心血管事件与颈动脉超声无创性测量的颈动脉壁内膜-中层厚度(IMT)增加之间存在很强的相关性。颈动脉IMT可作为亚临床心血管疾病的替代标志物。我们建议用8到10年的时间来确定亚临床心血管疾病的进展速度(IMT的变化)。这个队列中大约2800到3000名成员在1995-98年的临床就诊时进行了基线IMT测量，这些成员的成像和IMT测量将在200：5-2007重复进行。该项目的主要目的是研究以下主要假设：1.测量超过50年的传统心血管危险因素的过渡性暴露与颈动脉IMT的进展率呈正相关。2.在基线就诊前20年，基线颈动脉内中膜厚度和心血管危险因素的累积暴露比临时危险因素暴露更能预测8到10年后亚临床疾病的进展。3.与传统危险因素相比，C反应蛋白、同型半胱氨酸等新的危险因素对颈动脉粥样硬化进展的影响更大。该应用程序将为Framingham研究数据库添加亚临床心血管疾病特定部位变化的表型标记物。这补充了正在进行的关于亚临床心血管疾病的进展及其与过早心血管事件家族史和基因组标记物的相关性的研究。

DESCRIPTION (provided by applicant): Strong associations exist between cardiovascular events and increased carotid artery wall intima-media thickness (IMT) as measured non-invasively by carotid ultrasound. Carotid IMT is accepted as a surrogate marker of sub-clinical cardiovascular disease. We propose to determine the rate of progression of sub-clinical cardiovascular disease (change in IMT) over a period of 8 to 10 years. Imaging and IMT measurements of approximately 2800 to 3000 members of this cohort having had baseline IMT measurements at their 1995-98 clinic visit will be repeated in 200:5-2007. The principal aims of the project are to study the primary hypotheses that: 1. Interim exposure to traditional cardiovascular risk factors measured over 50 years is positively associated with the progression rate of carotid IMT. 2. Baseline carotid IMT and cumulative exposure to cardiovascular risk factors 20 years before the baseline visit are a better predictor of progression of sub-clinical disease after 8 to 10 years than the interim exposure to risk factors. 3. Novel risk factors such as C-reactive protein and homocysteine affect progression of carotid atherosclerosis more than traditional risk factors. This application will add a phenotypic marker of site-specific change in sub-clinical cardiovascular disease to the Framingham Study database. This complements ongoing research on the progression of sub-clinical cardiovascular disease and its associations with family history of premature cardiovascular events and genomic markers.