Coronary Atherosclerosis Evaluation by Arterial Wall MRI

动脉壁 MRI 评估冠状动脉粥样硬化

• 批准号: 7256403
• 负责人: JONATHAN S LEWIN
• 金额: $ 62.09万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7256403
• 关键词: Arterial Fatty Streak; Atherosclerosis; Beds; Calcium; Cardiovascular Diseases; Carotid Arteries; Clinical; Coronary; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Development; Disease; Disease Marker; Evaluation; Funding; Future; Gender; Goals; Hypertension; Imagery; Ionizing radiation; Lead; Lipids; Longitudinal Studies; Magnetic Resonance Imaging; Measurement; Measures; Medial; Methods; Minor; Participant; Pathologic; Pathway interactions; Personal Satisfaction; Prospective Studies; Rate; Research Personnel; Risk; Risk Factors; Role; Sampling; Score; Serological; Smoking; Staging; Stenosis; Surrogate Markers; Systemic disease; Testing; Thick; Time; Ultrasonography; arterial remodeling; burden of illness; calcification; cohort; glucose metabolism; improved; intima media; novel; programs

DESCRIPTION (provided by applicant): Direct and noninvasive visualization of the extent of coronary artery atherosclerosis is a major goal in the effort to assess coronary heart disease. Coronary artery calcium and carotid intima medial thickness are examples of surrogate markers of coronary atherosclerosis that attempt to non-invasively define the extent of coronary artery disease present. Coronary calcium in particular is a marker for coronary atherosclerotic burden but is a minor component of total plaque and is not present in early plaque. Coronary artery wall MRI is a new method to directly measure the thickness of the coronary artery wall, and is the only existing noninvasive test without ionizing radiation that can directly interrogate the coronary vasculature and provide a measure of disease burden at this early stage. Prior studies have shown increased coronary artery wall thickness is detected by MRI when no or minimal narrowing of the coronary artery lumen is present. Thus, this study proposes to assess the role of coronary artery wall thickness as a measure of early atherosclerotic disease using MRI, and 2) to determine the relationship of coronary artery wall thickness to both known risk and other noninvasive surrogate markers of atherosclerosis. This study will be performed within the context of the Multi-Ethnic Study of Atherosclerosis (MESA), an NHBLI prospective study of 6814 subjects without clinically manifest atherosclerotic disease. The underlying hypothesis of the MESA study is that the pathway from risk factors to clinical disease is through the development of subclinical disease. The MESA cohort is well characterized in terms of traditional risk factors and serologic markers for atherosclerotic disease. There is also phenotypic characterization of the cohort using carotid ultrasound, coronary calcium and MRI of the carotid and aortic wall. The specific aims of this application are to 1) determine the relationship between known risk factors for cardiovascular disease and coronary artery wall thickness, 2) determine the relationship between coronary artery wall thickness and coronary artery calcium and carotid wall thickness and 3) measure the progression of coronary artery wall thickness over time. The combination of direct coronary artery wall thickness measurement by MRI with the existing disease markers in MESA will be an effective way to assess the relationship of these markers to early pathologic changes in the coronary arterial bed. The ability to directly define the extent of coronary atherosclerosis at an early stage should lead to an improved understanding of coronary risk factors and their impact on atherosclerosis development.

描述（由申请人提供）：冠状动脉粥样硬化程度的直接和非侵入性可视化是评估冠心病的主要目标。冠状动脉钙和颈动脉内膜厚度是冠状动脉粥样硬化的替代标志物的实例，试图非侵入性地定义存在冠状动脉疾病的程度。冠状动脉钙特别是冠状动脉粥样硬化负担的标记，但是总斑块的次要组成部分，在早期斑块中不存在。冠状动脉壁MRI是一种直接测量冠状动脉壁厚度的新方法，并且是现有的无创试验，而无需电离辐射，可以直接询问冠状动脉脉管系统并在此早期提供疾病负担的量度。先前的研究表明，当没有或最小的冠状动脉腔较窄时，MRI检测到冠状动脉壁的厚度增加。因此，这项研究提议评估使用MRI作为早期动脉粥样硬化疾病的冠状动脉壁厚度的作用，以及2）确定动脉粥样硬化的冠状动脉壁厚与已知风险和其他非侵入性替代标记的关系。这项研究将在动脉粥样硬化的多种族研究（MESA）的背景下进行，这是对6814名没有临床明显动脉粥样硬化疾病的受试者的NHBLI前瞻性研究。 MESA研究的基本假设是，从危险因素到临床疾病的途径是通过亚临床疾病的发展。梅萨队列的特征是传统的危险因素和动脉粥样硬化疾病的血清学标记。使用颈动脉和主动脉壁的颈动脉超声，冠状动脉钙和MRI，对队列也具有表型表征。本应用的具体目的是1）确定心血管疾病的已知风险因素与冠状动脉壁厚的关系，2）确定冠状动脉壁厚与冠状动脉钙与颈动脉壁厚度与颈动脉壁厚与3）测量冠状动脉壁厚度的进展。 MRI直接的冠状动脉壁厚度测量与MESA中现有疾病标记的结合将是评估这些标记与冠状动脉床早期病理变化的关系的有效方法。在早期阶段直接定义冠状动脉粥样硬化程度的能力应提高人们对冠状动脉危险因素的了解及其对动脉粥样硬化发展的影响。