Epidemiology and Mechanisms of ECG Abnormalities: Young Adulthood to Middle Age

描述(由申请人提供)：拟议研究的总体目标是对现有的12导联心电图(EGG)描记进行编码，以便：1)评估不同种族年轻人的心电图异常发生率；2)检查心电图异常发生和进展的潜在风险因素；3)调查心电图异常与其他亚临床心脏病指标(亚临床动脉粥样硬化、左室心肌肥厚和自主神经功能障碍)之间的关系；以及4)评估黑人和白人心电图异常发生率和相关模式的差异。最终，这项研究的结果可能有助于确定静息心电图(一种低成本、非侵入性、可广泛使用且易于解释的临床测试)在心血管疾病一级预防中的潜在作用。我们将在青年冠状动脉风险发展(CARDIA)研究的男性和女性参与者中进行这项研究，他们在1985-1986年间登记时年龄在18岁到30岁之间。我们计划使用最先进的技术和标准化的明尼苏达编码和Novacode方法，在0年级、7年级和20年级的考试中对CARDIA参与者获得的静息12导联心电图进行编码。该项目将首次分析年轻的黑人和白人成年人在这些异常出现的关键年龄段内的长期心电变化。这项拟议的研究是独特的、及时的和极具成本效益的，因为它利用了一项大型的、预先存在的、双相流行病学队列研究，使用了高质量的连续12导联心电轨迹(以前收集但从未编码)，以及以前收集的心血管危险因素、亚临床动脉粥样硬化和左心室形态的其他测量。在可预见的未来，其他队列研究不太可能提供类似的数据。CARDIA的静息12导联心电图为研究提供了宝贵的资源，可以为心电图异常和心血管疾病之间的流行病学联系提供重要的见解。这项拟议的研究将填补我们对年轻人心电图异常的流行病学、病因学和自然病史知识的关键空白。此外，它将提供重要的见解，以了解心电图异常与心血管疾病风险增加相关的潜在机制，以及这些机制在黑人和白人之间的差异，最终可能导致年轻人预防策略的改进。

DESCRIPTION (provided by applicant): The overall objective of the proposed research is to code existing serial 12-lead electrocardiographic (EGG) tracings in order to: 1) assess the incidence of ECG abnormalities in young adults of different races; 2) examine potential risk factors for development and progression of ECG abnormalities; 3) investigate associations between ECG abnormalities and other measures of subclinical cardiac disease (subclinical atherosclerosis, left ventricular mass/hypertrophy, and autonomic dysfunction); and 4) assess differences in incidence and patterns of associations of ECG abnormalities in blacks and whites. Ultimately, the results of the study may help to define a potential role for the resting ECG (a low-cost, non-invasive, widely available and easily interpretable clinical test) in primary prevention of CVD. We will perform this study in the large biracial cohort of men and women participants of the Coronary Artery Risk Development in Young Adults (CARDIA) Study, who were aged 18 to 30 years at enrollment in 1985-1986. We plan to code resting 12-lead ECGs obtained from CARDIA participants at the Year 0, Year 7, and Year 20 examinations, using state-of- the-art technology and standardized Minnesota Code and Novacode methods. This project will provide the first analyses of long-term ECG changes in young black and white adults, during a critical age period when these abnormalities appear to develop. The proposed study is unique, timely and extremely cost-effective in that it takes advantage of a large, pre-existing, biracial epidemiologic cohort study with high-quality serial 12- lead ECG tracings (previously collected but never coded) and with other previously collected measures of CVD risk factors, subclinical atherosclerosis and left ventricular morphology. It is unlikely that other cohort studies will be able to provide similar data for the foreseeable future. The resting 12-lead ECGs from CARDIA represent a precious resource for research that can offer important insights into the epidemiologic associations between ECG abnormalities and CVD. The proposed research will fill critical gaps in our knowledge of the epidemiology, etiology and natural history of ECG abnormalities in young adults. Furthermore, it will provide important insights into the potential mechanisms by which ECG abnormalities are associated with increased risk for CVD, and how these mechanisms may differ between blacks and whites, which may ultimately lead to improvements in preventive strategies for young adults.