Cardiac Imaging of Thoracic Fat and Aortic Stiffness in Older High Risk Patients

老年高危患者胸部脂肪和主动脉僵硬的心脏成像

• 批准号: 8316188
• 负责人: Tina E Brinkley
• 金额: $ 11.17万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8316188
• 关键词: Abdomen; Address; Adipocytes; Adipose tissue; Admission activity; Aging; Ancillary Study; Aorta; Area; Atherosclerosis; Biological Markers; Biology; Biometry; Blood Vessels; Blood flow; Body fat; Cardiac; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Central obesity; Chest; Communities; Coronary; Coronary Arteriosclerosis; Data; Diabetes Mellitus; Disease; Dobutamine; Elderly; Enrollment; Environment; Epidemiologic Studies; Epidemiology; Event; Exercise; Fatty acid glycerol esters; Future; Geriatrics; Gerontology; Goals; Health Care Costs; Heart; Heart failure; Hospitalization; Hospitals; Hypertension; Image; Individual; Insulin; Insulin Resistance; Internal Medicine; Intervention; Knowledge; Learning; Lung; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Mediating; Mentored Research Scientist Development Award; Mentors; Morbidity - disease rate; Myocardial Infarction; Obesity; Obesity associated cardiovascular disease; Older Population; Outcome; Participant; Patients; Pericardial body location; Population; Prospective Studies; Pulmonary Edema; Qualifying; Randomized Controlled Trials; Research; Research Personnel; Research Training; Rest; Risk; Risk Factors; Role; Statistical Methods; Stress; Stroke; Testing; Time; Training; Vasodilation; Visceral; adipokines; adiponectin; age related; arterial stiffness; base; cardiovascular disorder risk; cardiovascular risk factor; career; clinically significant; cohort; cost effective; follow-up; glucose uptake; high risk; improved; indexing; innovation; instructor; interest; medical schools; mortality; multidisciplinary; novel; population based; prevent; public health relevance; response; skills; sound; therapy design

DESCRIPTION (provided by applicant): The candidate is an Instructor in the Section on Gerontology and Geriatric Medicine in the Department of Internal Medicine. Her previous research focused on the effects of exercise training on changes in cardiovascular disease risk factors in older persons. Receipt of this K01 award will provide training in imaging, epidemiology, and vascular biology/mechanics, thereby equipping her with the skills necessary to become an independent researcher in the field of cardiovascular aging. Research: The proposed research will be an ancillary study to the Vascular Stiffness and Pulmonary Edema Study, a prospective study examining the association between dobutamine stress-induced changes in aortic stiffness and flash pulmonary edema warranting hospital admission in older high risk patients. The major aims of the present study are to 1) quantify the relationship between pericardial and perivascular adipose tissue (PCAT, PVAT) and dynamic changes in aortic stiffness in response to dobutamine-induced stress and 2) determine whether PCAT and PVAT predict cardiac events over a mean follow-up of 3.5 years. Potential mechanisms underlying the association between PCAT and PVAT and the outcomes will also be examined, including the possibility of a local effect that is perhaps mediated by adipocyte-derived factors (i.e. adipokines). Of particular interest is adiponectin, which is expressed in both PCAT and PVAT and has potent effects on cardiovascular function and insulin action. The hypotheses are that PCAT and PVAT will be positively associated with dynamic changes in aortic stiffness and that higher levels will be associated with an increased risk of future cardiac events. We also anticipate that these relationships will be independent of traditional risk factors, as well as abdominal visceral fat, adiponectin, and insulin resistance. This K01 award will provide the candidate with protected research time and mentored training to learn the technical and statistical methods to test these specific aims. The knowledge she acquires during the conduct of this study will ultimately provide her with expertise in the application of MRI to the assessment of interventions designed to alter the trajectory of age- related changes in vascular function and cardiovascular disease risk. Environment: There is an enriched research and training environment in aging-related studies within the WFU School of Medicine. The successful completion of the candidate's research and career goals will be guided by a highly-qualified, multidisciplinary team of mentors and consultants with expertise in epidemiology (Drs. Kritchevsky and Ding), cardiac imaging (Dr. Hundley), regional body fat distribution (Drs. Nicklas and Ding), cardiovascular aging (Dr. Kitzman), and biostatistics (Dr. Leng). PUBLIC HEALTH RELEVANCE: This study will help to refine the relationship between obesity and cardiovascular disease risk by determining the importance of fat around the heart and blood vessels in relation to aortic stiffness and risk of future cardiac events. This knowledge will be useful in developing randomized controlled trials of interventions that may reduce the morbidity, mortality, and health care costs associated with cardiovascular diseases.

描述（由申请人提供）：候选人是内科老年学和老年医学科的讲师。她之前的研究重点是运动训练对老年人心血管疾病危险因素变化的影响。获得 K01 奖项将为她提供影像学、流行病学和血管生物学/力学方面的培训，从而使她具备成为心血管衰老领域的独立研究员所需的技能。研究：拟议的研究将是血管僵硬和肺水肿研究的辅助研究，该研究是一项前瞻性研究，旨在检查多巴酚丁胺应激引起的主动脉僵硬变化与老年高危患者需要入院的突发性肺水肿之间的关联。本研究的主要目的是 1) 量化心包和血管周围脂肪组织 (PCAT、PVAT) 与主动脉僵硬度响应多巴酚丁胺诱导的应激的动态变化之间的关系，以及 2) 确定 PCAT 和 PVAT 是否能够预测心脏事件平均随访时间为 3.5 年。还将检查 PCAT 和 PVAT 与结果之间关联的潜在机制，包括可能由脂肪细胞衍生因子（即脂肪因子）介导的局部效应的可能性。特别令人感兴趣的是脂联素，它在 PCAT 和 PVAT 中表达，对心血管功能和胰岛素作用具有强大的影响。假设 PCAT 和 PVAT 与主动脉僵硬度的动态变化呈正相关，并且较高水平将与未来心脏事件风险增加相关。我们还预计这些关系将独立于传统的危险因素，以及腹部内脏脂肪、脂联素和胰岛素抵抗。 K01 奖项将为候选人提供受保护的研究时间和指导培训，以学习测试这些特定目标的技术和统计方法。她在进行这项研究期间获得的知识最终将为她提供应用 MRI 评估干预措施的专业知识，这些干预措施旨在改变与年龄相关的血管功能和心血管疾病风险变化的轨迹。环境：WFU 医学院在衰老相关研究方面拥有丰富的研究和培训环境。候选人的研究和职业目标的成功完成将由高素质、多学科的导师和顾问团队指导，他们具有流行病学（Kritchevsky 博士和 Ding 博士）、心脏成像（Hundley 博士）、区域身体脂肪分布（ Nicklas 博士和 Ding 博士）、心血管衰老（Kitzman 博士）和生物统计学（Leng 博士）。 公共健康相关性：这项研究将通过确定心脏和血管周围脂肪与主动脉僵硬度和未来心脏事件风险之间的重要性，有助于完善肥胖与心血管疾病风险之间的关系。这些知识将有助于开展干预措施的随机对照试验，这些干预措施可能会降低与心血管疾病相关的发病率、死亡率和医疗保健费用。