Epidemiologic Determinants of Change in Cardiac Structure and Function (ECHO-SOL 2)

心脏结构和功能变化的流行病学决定因素 (ECHO-SOL 2)

• 批准号: 9245726
• 负责人: Carlos Jose Rodriguez
• 金额: $ 75.09万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9245726
• 关键词: Accounting; Acculturation; Adult; Age; Area; Body mass index; Cardiac; Cardiovascular Diseases; Chronic Disease; Chronic stress; Clinical; Clinical Trials; Collaborations; Complement; Contracts; Data; Databases; Development; Diabetes Mellitus; Echocardiography; Education; Epidemic; Epidemiologic Factors; Framingham Heart Study; Functional disorder; Funding; Future; Generations; Geometry; Goals; Health Planning; Heart Abnormalities; Heart Diseases; Heart failure; High Prevalence; Hispanic Community Health Study/Study of Latinos; Hispanics; Hypertension; Income; Individual; Investigation; Latino; Learning; Left; Left Ventricular Ejection Fraction; Left Ventricular Hypertrophy; Left Ventricular Mass; Letters; Link; Longitudinal cohort study; Measures; Mechanics; Myocardial; Myocardial dysfunction; Not Hispanic or Latino; Obesity; Participant; Pathway interactions; Pattern; Phenotype; Prediabetes syndrome; Predictive Factor; Prevalence; Prevention; Process; Public Health; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Signal Transduction; Social support; Socioeconomic Factors; Structure; Study of Latinos; Techniques; Tissues; Torsion; Translating; United States; United States National Institutes of Health; Ventricular; Vulnerable Populations; Work; base; cardiogenesis; cardiovascular health; cardiovascular risk factor; cohort; cost effective; epidemiology study; ethnic minority population; follow-up; high risk; innovation; mortality; novel; novel strategies; population based; prehypertension; psychosocial; public health relevance; racial and ethnic; residence; screening; socioeconomics; trend

 DESCRIPTION (provided by applicant): Hispanics are under-represented in heart failure (HF) clinical trials and epidemiologic studies. The contract funded Hispanic Community Health Study/Study of Latinos (HCHS/SOL) did not include a provision for a baseline echo exam. The NIH-funded Echocardiographic Study of Latinos (ECHO-SOL; PI Dr. Rodriguez) helped fill this critical gap. We successfully performed echo exams using techniques such as tissue Doppler and speckle tracking in a representative subset of the HCHS/SOL baseline cohort. Our preliminary data show that despite a relatively young age of 56+0.4 years, the prevalence of left ventricular (LV) hypertrophy, abnormal LV geometry and diastolic dysfunction is higher among Hispanics than previously reported in non- Hispanic whites. In addition, acculturation, a factor relevant to Hispanics but understudied in relation to HF risk, was significantly associated with a higher prevalence of cardiac structural and functional abnormalities. In HF, progression from Stage A (HF risk factors alone) to Stage B (abnormalities of cardiac structure and function) to Stage C (clinical symptomatic HF; either with preserved [HFpEF] or reduced EF [HFrEF]) is an incredibly important process. There is a shortage of longitudinal cohort studies on progression across the HF stages in racial/ethnic minorities. Longitudinal data are essential to determine if distinct patterns of change in cardiac phenotypes from stage A to B HF can identify individuals on a trajectory towards developing clinical HF. Cohorts of non-Hispanics, such as the FHS and CHS, show that changes in cardiac echo parameters within a 4-5 year period can predict incident HF. Our ECHO-SOL data show the feasibility of assessing cardiac progression with serial echo exams in our unique cohort. However, the current contract funded HCHS/SOL 2nd exam does not include echo exams on ECHO-SOL participants. Thus, we propose to leverage the unique resources of ECHO-SOL and the HCHS/SOL 2nd exam in order to repeat a high quality echo (ECHO-SOL 2) in the ECHO-SOL cohort on average five years post- baseline. The overall goal is to determine how the transition in traditional HF risk factors impacts longitudinal change of cardiac abnormalities by assessing serial change in echo parameters in relation to the rich clinical, sociocultural, socioeconomic and psychosocial HCHS/SOL database. ECHO-SOL 2 represents an innovative and cost-effective approach to advance our understanding of the links between progression of HF risk factor with progression of abnormal cardiac structure and function. ECHO-SOL 2 will identify patterns of HF risk factor progression and the trajectory of early cardiac dysfunction that can differentiate Hispanic adults as more or less likely to develop HF; utilizing the conjoint contributions of conventional assessment of cardiac structure and systolic / diastolic function with more novel echo measures (LV strain and twist). ECHO-SOL 2 will facilitate the screening and identification of Hispanics who are at greatest HF risk, and can then be targeted for aggressive risk factor control to lower the burden of clinical HF in this vulnerable population.

 描述（由应用提供）：西班牙裔人的心力衰竭（HF）临床试验和流行病学研究的代表性不足。该合同资助了拉丁美洲人的西班牙裔社区健康研究（HCHS/SOL），不包括基线回声考试的规定。 NIH资助的拉丁裔超声心动图研究（Echo-Sol; Pi Rodriguez博士）帮助填补了这一关键空白。我们在HCHS/SOL基线队列的代表性子集中成功地使用了组织多普勒和斑点跟踪的技术成功地进行了回声检查。我们的初步数据表明，尽管相对年轻的年龄为56+0.4岁，但在西班牙裔中，左心室（LV）肥大，LV几何形状异常和舒张功能障碍的患病率还是比以前在非西班牙裔白人中报道的要高。此外，适应性是与西班牙裔有关的因素，但与HF风险有关，与心脏结构和功能异常的较高患病率显着相关。在HF中，从A期（仅HF风险因素）到B期（心脏结构和功能异常）到C期C（临床症状HF；保留[HFPEF]或减少EF [HFREF]）的进展是一个非常重要的过程。关于种族/族裔少数民族的HF阶段进展的纵向队列研究短缺。纵向数据对于确定从A阶段到B HF的心脏表型的不同变化模式是否可以识别出轨迹上的临床HF的轨迹。非西班牙裔人群（例如FHS和CHS）表明，在4 - 5年内心脏回声参数的变化可以预测事件HF。我们的Echo-SOL数据表明，在我们独特的队列中，通过串行回声考试评估心脏进展的可行性。但是，当前资助的HCHS/SOL第二考试的合同不包括有关Echo-SOL参与者的回声考试。这是我们建议利用Echo-SOL和HCHS/SOL第二考试的独特资源，以便在基线五年后平均在Echo-SOL队列中重复高质量的Echo（Echo-Sol 2）。总体目标是确定传统HF风险因素的过渡如何影响纵向 通过评估与丰富的临床，社会文化，社会经济和社会心理HCHS/SOL数据库有关的回声参数的串行变化，通过评估回声参数的串行变化来改变心脏异常。 Echo-SOL 2代表了一种创新且具有成本效益的方法，可以促进我们对HF风险因素与心脏异常结构和功能进展之间的联系的理解。 Echo-SOL 2将确定HF危险因素进展的模式和早期心脏功能障碍的轨迹，这些模式可以将西班牙裔成年人区分为或多或少地发展HF。利用更新颖的回声测量（LV应变和扭曲）对心脏结构和收缩 /舒张功能的常规评估的联合贡献。 Echo-SOL 2将促进对HF风险最大的西班牙裔的筛查和识别，然后可以针对积极的危险因素控制，以降低该脆弱人群的临床HF燃烧。