Prognostic Utility of Absolute Coronary Microvascular Function by PET/CT

PET/CT 绝对冠状动脉微血管功能的预后用途

• 批准号: 8473264
• 负责人: Sharmila Dorbala
• 金额: $ 14.1万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8473264
• 关键词: Adverse event; Affect; Age; Amyloid; Amyloidosis; Angiography; Atherosclerosis; Blood flow; Cardiac; Cardiac Catheterization Procedures; Cardiac Death; Cardiomyopathies; Cardiovascular Diseases; Clinical; Clinical Investigator; Collaborations; Congestive Heart Failure; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Defect; Development; Dyes; Electric Countershock; Enrollment; Evaluation; Event; Foundations; Functional disorder; Future; Gender; Goals; Gold; Heart; Heart Diseases; Heart failure; Hospitalization; Hospitals; Hypoxia; Image; Implantable Defibrillators; Individual; Infarction; Infiltration; Injection of therapeutic agent; Instruction; Ischemia; Isotopes; Left; Left Ventricular Hypertrophy; Left Ventricular Remodeling; Life; Link; Master' s Degree; Measures; Mentors; Metabolic; Myocardial Ischemia; Myocardial perfusion; Myocardial tissue; Myocardium; Nature; Nuclear; Obstruction; Outcome; Pathology; Pathway interactions; Patients; Perfusion; Physiologic intraventricular pressure; Play; Positron-Emission Tomography; Principal Investigator; Process; Public Health; Public Health Schools; Relative (related person); Reporting; Rest; Risk; Risk Factors; Risk Marker; Role; Rubidium; Severities; Stenosis; Stratification; Stress; Sudden Death; Surface; Syndrome; Tachyarrhythmias; Technetium; Testing; Thallium; Tissues; Unstable angina; Vascular blood supply; Vasodilator Agents; Ventricular; Ventricular Arrhythmia; Woman; abstracting; acute coronary syndrome; adverse outcome; cardiovascular imaging; career; design; experience; follow-up; hypertensive heart disease; improved; indexing; prognostic; skills; tool

DESCRIPTION (provided by applicant): The purpose of this proposal is to promote scientific development and investigative skills of the candidate in order that she may become an independent clinical investigator. The noninvasive cardiovascular imaging center at the Brigham and Women's Hospital provides the Ideal setting in which the candidate will study the prognostic value of coronary microvascular function, while enrolled in a Masters degree in Public Health at the Harvard School of Public Health. Through the collaboration with the clinical mentor, and highly experienced scientific advisors, the candidate will obtain a foundation for the development of an independent academic career. The link between myocardial ischemia, epicardlal coronary artery disease (CAD) and survival Is well established. More recently, coronary microvascular dysfunction has been reported in several clinical syndromes such as hypertensive heart disease, cardiomyopathy and syndrome X, In subjects without obstructive epicardlal CAD. Preliminary evidence suggests that microvascular dysfunction is associated with worse outcomes. Until recently, evaluation of coronary microvascular function has been impeded by methodological limitations, and hence, its nature and mechanisms remain speculative. Positron emission tomography (PET) represents an extremely powerful tool to assess coronary microvascular function. The central goal of this study is to determine the prognostic value of coronary microvascular function using Rubldlum-82 PET. The candidate has demonstrated the prognostic value of relative Rubldium-82 PET, reflecting severity of epicardlal CAD. In specific Aims 1-3, the candidate will study the value of coronary microvascular function to predict major adverse cardiac events of sudden death, risk of left ventricular remodeling/heart failure, and risks from progression to obstructive epicardlal CAD. We anticipate that the proposed studies outlined here will provide important mechanistic links between coronary microvascular dysfunction and cardiac events. The results of these studies will serve as a foundation to design future studies of specific therapies directed at improving coronary microvascular function and clinical outcomes. RELEVANCE (See instructions): The big coronary arteries supplying blood to the heart course on the surface and are visible by dye injection (angiography), but the vessels entering the heart muscle are very small and not seen on angiography. These microvessels play a major role in blood flow to the heart, especially during activity. The purpose of this study is to find out If microcirculatory abnormalities can predict risk of future adverse outcomes from heart disease. (End of Abstract)

描述（由申请人提供）：本提案的目的是促进候选人的科学发展和研究技能，以便她成为一名独立的临床研究者。布莱根妇女医院的无创心血管成像中心提供了理想的环境，候选人可以在哈佛大学公共卫生学院攻读公共卫生硕士学位的同时，研究冠状动脉微血管功能的预后价值。通过与临床导师和经验丰富的科学顾问的合作，候选人将为独立学术生涯的发展奠定基础。心肌缺血、心外膜冠状动脉疾病 (CAD) 和生存之间的联系已得到充分证实。最近，在几种临床综合征中报道了冠状动脉微血管功能障碍，例如高血压性心脏病、心肌病和X综合征，在没有阻塞性心外膜CAD的受试者中。初步证据表明，微血管功能障碍与较差的预后相关。直到最近，冠状动脉微血管功能的评估一直受到方法学限制的阻碍，因此，其性质和机制仍然是推测性的。正电子发射断层扫描 (PET) 是评估冠状动脉微血管功能的极其强大的工具。本研究的中心目标是使用 Rubldlum-82 PET 确定冠状动脉微血管功能的预后价值。候选人已经证明了相对 Rubldium-82 PET 的预后价值，反映了心外膜 CAD 的严重程度。在具体目标 1-3 中，考生将研究冠状动脉微血管功能的价值，以预测猝死等主要不良心脏事件、左心室重构/心力衰竭的风险以及进展为阻塞性心外膜 CAD 的风险。我们预计这里概述的拟议研究将提供冠状动脉微血管功能障碍和心脏事件之间的重要机制联系。这些研究的结果将作为设计未来研究旨在改善冠状微血管功能和临床结果的特定疗法的基础。相关性（参见说明）：向表面的心脏供血的大冠状动脉通过染料注射（血管造影）可见，但进入心肌的血管非常小，在血管造影中看不到。这些微血管在流向心脏的血液中发挥着重要作用，尤其是在活动期间。本研究的目的是查明微循环异常是否可以预测未来心脏病不良后果的风险。 （摘要完）

项目成果

Yield of downstream tests after exercise treadmill testing: a prospective cohort study.

运动跑步机测试后下游测试的产量：一项前瞻性队列研究。

• 发表时间: 2014-04-08
• 影响因子: 24
• 作者: Christman, Mitalee P;Bittencourt, Marcio Sommer;Hulten, Edward;Saksena, Ekta;Hainer, Jon;Skali, Hicham;Kwong, Raymond Y;Forman, Daniel E;Dorbala, Sharmila;O'Gara, Patrick T;Di Carli, Marcelo F;Blankstein, Ron
• 通讯作者: Blankstein, Ron

Prognostic significance of impaired chronotropic response to pharmacologic stress Rb-82 PET.

药物应激 Rb-82 PET 变时反应受损的预后意义。

• 发表时间: 2014-04
• 作者: Bellam, Naveen;Veledar, Emir;Dorbala, Sharmila;Di Carli, Marcelo F;Shah, Sana;Eapen, Danny;Quyyumi, Arshed;Beanlands, Rob S B;Merhige, Michael E;Williams, Brent A;Chow, Benjamin J W;Min, James K;Berman, Daniel S;Shaw, Leslee J
• 通讯作者: Shaw, Leslee J

Prognostic value of stress myocardial perfusion positron emission tomography: results from a multicenter observational registry.

应激性心肌灌注正电子发射断层扫描的预后价值：来自多中心观察登记的结果。

• DOI: 10.1016/j.jacc.2012.09.043
• 发表时间: 2013-01-15
• 期刊: Journal of the American College of Cardiology
• 影响因子: 24
• 作者: Dorbala, Sharmila;Di Carli, Marcelo F.;Beanlands, Rob S.;Merhige, Michael E.;Williams, Brent A.;Veledar, Emir;Chow, Benjamin J. W.;Min, James K.;Pencina, Michael J.;Berman, Daniel S.;Shaw, Leslee J.
• 通讯作者: Shaw, Leslee J.

Safety and feasibility of regadenoson use for suboptimal heart rate response during symptom-limited standard Bruce exercise stress test.

在症状限制的标准布鲁斯运动压力测试期间，使用热加腺苷治疗次优心率反应的安全性和可行性。

• 发表时间: 2012-10
• 作者: Partington, Sara L;Lanka, Viswanatha;Hainer, Jon;Blankstein, Ron;Skali, Hicham;Forman, Daniel E;Di Carli, Marcelo F;Dorbala, Sharmila
• 通讯作者: Dorbala, Sharmila

Imaging cardiac amyloidosis: a pilot study using ¹⁸F-florbetapir positron emission tomography.

心脏淀粉样变性成像：使用 1F-氟倍他吡正电子发射断层扫描的初步研究。

• 发表时间: 2014-09
• 影响因子: 9.1
• 作者: Dorbala, Sharmila;Vangala, Divya;Semer, James;Strader, Christopher;Bruyere Jr, John R;Di Carli, Marcelo F;Moore, Stephen C;Falk, Rodney H
• 通讯作者: Falk, Rodney H