The Vascular, Autonomic, and Myocardial Phenotypes in Women with Myocardial Infarction due to Spontaneous Coronary Artery Dissection

项目说明/摘要 候选人：Tweet博士的长期目标是成为一名独立的临床研究员 女性冠状动脉疾病领域。她的短期目标是探索血管， 有自发性冠状动脉病史的女性的自主神经和微血管表型 动脉夹层(SCAD)。为了实现这些目标，Tweet博士将：1)获得专业知识 她的科学目标所需；2)通过课程和 生物统计学支持；3)发展科学领导技能和协作关系，以 将此字段向前移动。环境：梅奥诊所SCAD注册中心是最大的 国际SCAD注册。推特博士的主要导师乔伊纳博士和她的职业指导 委员会拥有指导Tweet博士职业生涯的专业知识和导师素质 发展成为一名内科医生-科学家。背景：慢性阻塞性肺疾病是导致 女性非动脉粥样硬化性急性冠脉综合征。大多数患者没有传统的 风险因素，如吸烟、高脂血症或糖尿病。相反，外周动脉 大多数患者可观察到纤维肌肉发育不良等异常情况。SCAD IS 与压力、运动和怀孕有关。复发的SCAD发生在10%-30%的 病人。具体目标：我们将致力于评估动脉结构和力学(目标1)， 女性SCAD患者的神经血管功能(目标2)和微血管功能(目标3)。 研究设计和结果衡量：这是一项前瞻性研究，研究对象为 梅奥诊所SCAD诊所。测量将包括动脉厚度和僵硬， 交感神经压力感受性反射敏感性和自主神经对交感神经兴奋的反应 标准化应激源和多巴酚丁胺负荷心肌灌注超声心动图。 与应聘者职业目标的关系：申请中的项目将是 有助于应聘者的职业发展：科学管理和 领导技能，获取新的研究技术，并产生跨学科和 多机构协同联盟。因此，这是她研究生涯中合乎逻辑的下一步 进步。与NHLBI任务的关系：拟议的项目与 NHLBI用于了解疾病潜在病理生理机制的战略愿景 以及改善对影响妇女的疾病的研究。这与NHLBI的利益一致 在高血压、交感神经兴奋和心血管疾病风险方面。它也与 与培训下一代临床研究人员相关的更广泛的NIH目标。

PROJECT DESCRIPTION/ABSTRACT Candidate: Dr. Tweet’s long-term goal is to become an independent clinical investigator in the field of coronary artery disease in women. Her short-term goal is to explore the vascular, autonomic and microvascular phenotypes in women with a history of spontaneous coronary artery dissection (SCAD). To achieve these goals, Dr. Tweet will: 1) acquire the expertise required for her scientific aims; 2) improve her data analysis skills via coursework and biostatistical support; 3) develop scientific leadership skills and collaborative relationships to move this field forward. Environment: The Mayo Clinic SCAD Registry is the largest international SCAD registry. Dr. Tweet’s primary mentor, Dr. Joyner and her Career Advisory Committee have the expertise and mentorship qualities to guide Dr. Tweet’s career development as a physician-scientist. Background: SCAD is a leading cause of nonatheroembolic acute coronary syndromes in women. Most patients do not have traditional risk factors such as tobacco use, hyperlipidemia, or diabetes. Rather, peripheral arterial abnormalities such as fibromuscular dysplasia are observed in the majority of patients. SCAD is associated with stress, exercise, and pregnancy. Recurrent SCAD occurs in 10-30% of patients. Specific Aims: We will aim to assess arterial structure and mechanics (Aim #1), neurovascular function (Aim #2), and microvascular function (Aim #3) in women with SCAD. Study Design & Outcome Measures: This is a prospective study of women evaluated in the Mayo Clinic SCAD Clinic. Measurements will include arterial thickness and stiffness, sympathetic baroreflex sensitivity and autonomic responses to sympathoexcitatory to standardized stressors, and myocardial perfusion echocardiography with dobutamine stress. Relationship to Career Goals of the Candidate: The projects in the application will be instrumental for the candidate’s career development by facilitating: scientific management and leadership skills, acquisition of new research techniques, and generating interdisciplinary and multi-institutional collaborative alliances. Thus it is the next logical step in her research career progression. Relationship to the NHLBI Mission: The proposed project is consistent with the NHLBI strategic vision for understanding underlying pathophysiological mechanisms of disease and for improving study of diseases affecting women. It is consistent with the NHLBI’s interest in hypertension, sympathoexcitation and cardiovascular disease risk. It is also consistent with broader NIH goals related to training the next generation of clinical investigators.