Improving cardiovascular risk assessment using ultrasound imaging

应聘者描述(申请人提供)：应聘者Vijay Nambi，医学博士，受过成人心脏病学和血管医学方面的培训，目前是德克萨斯州休斯敦贝勒医学院动脉粥样硬化和血管内科医学系助理教授(终身教职)。候选人的长期目标是成为动脉粥样硬化和预防心脏病学领域的一名老牌独立研究员。为了实现他宣布的目标，他已经注册了临床科学家培训计划，目前正在一个博士咨询委员会的正式指导下，正在攻读临床研究博士学位。K-23职业发展奖将为候选人提供机会进行旨在利用新的生物标记物、基因分型和成像技术改善心血管风险预测的研究，重点是应用超声成像技术的新进展，以改进对动脉粥样硬化的评估，并在未来可能应用于心血管风险评估和管理。尽管现有的评估心血管风险的方法，如弗雷明翰风险评分是很好的，但它们未能识别出几个患心血管疾病的人。在Ballantyne博士和一群杰出顾问的指导下，候选人提出了以下建议：旨在改善心血管疾病风险预测的具体目标：1.评估颈动脉中膜中层厚度(C-IMT)和斑块的存在是否可以改善心血管(冠心病和中风)风险预测2.评估C-IMT增加9p21(已知与冠心病相关)单核苷酸多态(Rs1333049)是否会进一步改善CHD风险预测3.评估体外和体内三维超声成像是否可以可靠地估计动脉粥样硬化斑块的体积和组成，与磁共振成像和组织学相比；4.评估颈动脉僵硬是否与事件相关ARIC研究中的冠心病和中风，以及是否可以通过将基于超声心动图的新技术应用于颈动脉超声成像来可靠地测量颈动脉应变。相关性(见说明)：这项研究对公共卫生具有重大意义。改善心血管疾病风险预测的能力可能会使及时的干预措施能够降低心血管疾病的发病率，心血管疾病是西方世界的主要死亡原因。(摘要结束)

DESCRIPTION (provided by applicant): The candidate, Vijay Nambi, M.D., is a clinician trained in adult cardiology and vascular medicine who is currently an Assistant Professor (tenure track) in the Department of Medicine, Section of Atherosclerosis and Vascular Medicine at Baylor College of Medicine, Houston, Texas. The candidate's long term goal is to become an established independent investigator in the field of atherosclerosis and preventive cardiology. In order to achieve his stated goal, he has enrolled in the clinical scientist training program and is currently working towards a Ph.D. in clinical research with formal mentoring by a Ph.D. advisory committee. The K-23 career development award will provide the candidate with the opportunity to pursue research studies aimed at improving cardiovascular risk prediction using novel biomarkers, genotyping and imaging with a focus on application of new advances in ultrasound imaging technology to improve the evaluation of atherosclerosis with potential future application in cardiovascular risk assessment and management. Although existing methods to evaluate cardiovascular risk such as the Framingham risk scores are good, they fail to identify several individuals who develop cardiovascular disease. Under the guidance of Dr. Ballantyne and an outstanding group of advisors, the candidate proposes the following,specific aims aimed at improving cardiovascular disease risk prediction: 1. Evaluate whether carotid initima media thickness (C-IMT) and presence of plaque can improve cardiovascular (coronary heart disease [CHD] and stroke) risk prediction 2. Evaluate whether the addition of single nucleotide polymorphism (rs1333049) in chromosome 9p21 (known to be associated with CHD) to C-IMT will further improve CHD risk prediction 3. Evaluate whether ex-vivo and in-vivo 3-dimensional ultrasound imaging can reliably estimate atherosclerotic plaque volume and composition when compared to magnetic resonance imaging and histology and 4. Evaluate whether carotid artery stiffness is associated with incident CHD and stroke in the ARIC study and whether carotid artery strain can be reliably measured by adapting novel echocardiography-based technology to carotid ultrasound imaging. RELEVANCE (See instructions): This research is of significant public health importance. The ability to improve cardiovascular disease risk prediction may allow for timely interventions that decrease the incidence of cardiovascular disease, the leading cause of death in the western world. (End of Abstract)