MYOCARDIAL PERFUSION, RISK FACTORS, AND CORONARY CALCIUM

心肌灌注、危险因素和冠状动脉钙

• 批准号: 6390866
• 负责人: Michael Jerosch-Herold
• 金额: $ 51.75万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-20 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6390866
• 关键词: angiocardiography; bioimaging /biomedical imaging; cardiovascular disorder epidemiology; clinical research; coronary artery; coronary disorder; disease /disorder proneness /risk; early diagnosis; heart disorder diagnosis; human subject; magnetic resonance imaging; microcirculation

DESCRIPTION (Applicant's abstract): Impairment of coronary vasofunction is believed to be one of the earliest manifestations of coronary heart disease (CHD). The impact of risk factors such as elevated cholesterol levels, diabetes, hypertension, and smoking on the coronary microcirculation remains largely unknown. Our major objective is to investigate in a cross-sectional study whether an impairment of the myocardial perfusion reserve provides a marker of CHD by comparing it to other novel measures of subclinical vascular disease, and by testing its association with risk factors for CHD. The proposed study is ancillary to the Multi-Ethnic Study of Atherosclerosis ("MESA"), which is an NHLBI funded, prospective observational study of the characteristics of subclinical cardiovascular disease, i.e. disease detected non-invasively before it has produced signs and symptoms. In MESA new measures of subclinical disease such as coronary artery calcium and impaired brachial artery reactivity are to be examined to investigate their relationships to well-established risk factors and clinical events. We believe that myocardial perfusion reserve (MPR)is a useful measure of coronary vasofunction that should be included in an evaluation of new measures of subclinical disease. An impaired MPR appears to be a specific early indicator of the functional impairment of the microcirculation in patients with risk factors for coronary artery disease. We propose to use magnetic resonance imaging (MRI) as an advanced, quantitative imaging modality to determine in short (20 minute) exams the myocardial perfusion reserve in a group of 400 MESA participants. We hypothesize that impaired myocardial perfusion reserve indicates the presence of subclinical coronary atherosclerosis and coronary microvascular disease. As CHD remains the leading cause of death in the U.S. there is strong interest in developing such new measures of subclinical disease which would provide an early opportunity for intervention and lifestyle modification to prevent CHD and/or congestive heart failure.

描述（申请人的摘要）：冠状血管功能损伤是 被认为是冠心病的最早表现之一 （冠心病）。胆固醇水平升高等危险因素的影响 糖尿病、高血压和吸烟对冠状动脉微循环的影响仍然存在 很大程度上不为人知。我们的主要目标是进行横断面调查 研究心肌灌注储备受损是否会提供 通过将其与亚临床血管的其他新测量方法进行比较，确定冠心病的标志物 疾病，并通过测试其与冠心病危险因素的关联。拟议的 该研究是动脉粥样硬化多种族研究（“MESA”）的辅助项目，该研究 是一项 NHLBI 资助的前瞻性观察性研究，旨在研究 亚临床心血管疾病，即之前非侵入性检测到的疾病 它已经产生了迹象和症状。 MESA 亚临床疾病的新措施 例如冠状动脉钙化和肱动脉反应性受损 进行检查以调查其与既定风险因素的关系 和临床事件。我们认为心肌灌注储备（MPR）是 冠状动脉血管功能的有用测量，应包含在 评估亚临床疾病的新措施。 MPR 受损似乎 是功能障碍的特定早期指标 有冠状动脉疾病危险因素的患者的微循环。我们 建议使用磁共振成像（MRI）作为一种先进的、定量的 成像方式可在短时间内（20 分钟）检查心肌 400 名 MESA 参与者的灌注储备。我们假设 心肌灌注储备受损表明存在亚临床 冠状动脉粥样硬化和冠状动脉微血管疾病。由于 CHD 仍然是 是美国主要的死亡原因，人们对开发此类药物有浓厚的兴趣 亚临床疾病的新措施将提供早期机会 进行干预和改变生活方式以预防冠心病和/或充血 心脏衰竭。