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)

基本信息

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
项目类别：
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

项目摘要

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（由申请人提供）：西班牙裔在心力衰竭 (HF) 临床试验和流行病学研究中的代表性不足。资助的西班牙裔社区健康研究/拉丁裔研究 (HCHS/SOL) 的合同不包括基线回波检查的条款。 NIH 资助的拉丁裔超声心动图研究（ECHO-SOL；PI Dr. Rodriguez）帮助填补了这一关键空白，我们使用组织多普勒和斑点跟踪等技术成功地进行了回声检查。在 HCHS/SOL 基线队列的一个代表性子集中，我们的初步数据显示，尽管西班牙裔人的年龄相对较年轻（56+0.4 岁），但左心室 (LV) 肥大、左心室几何结构异常和舒张功能障碍的患病率比以前更高。此外，文化适应是一个与西班牙裔相关但与心力衰竭风险相关的因素，与心力衰竭的较高患病率显着相关。从 A 期（仅存在心力衰竭危险因素）到 B 期（心脏结构和功能异常）再到 C 期（临床症状性心力衰竭；[HFpEF] 保留或 EF 减少 [HFrEF]）的进展是一个极其重要的过程。缺乏关于少数族裔心力衰竭阶段进展的队列纵向研究，对于确定从 A 期心力衰竭到 B 期心力衰竭的心脏表型变化的不同模式是否可以识别个体走向临床心力衰竭的轨迹，纵向数据至关重要。非西班牙裔群体（例如 FHS 和 CHS）表明，4-5 年内心脏回波参数的变化可以预测心力衰竭的发生。我们的 ECHO-SOL 数据显示了在我们的连续回波检查中评估心脏进展的可行性。然而，当前合同资助的 HCHS/SOL 第二次考试不包括 ECHO-SOL 参与者的 echo 考试，因此，我们建议利用 ECHO-SOL 和 ECHO-SOL 的独特资源。 HCHS/SOL 第二次检查，以便在基线后平均五年内重复 ECHO-SOL 队列中的高质量回波 (ECHO-SOL 2) 总体目标是确定传统心力衰竭风险因素的转变如何影响纵向。通过评估与丰富的临床、社会文化、社会文化和心理社会 HCHS/SOL 数据库相关的回声参数的连续变化来改变心脏异常的变化，ECHO-SOL 2 代表了一种创新且具有成本效益的方法，可促进我们对心脏异常进展之间联系的理解。伴随心脏结构和功能异常进展的心力衰竭危险因素 ECHO-SOL 2 将识别心力衰竭危险因素的进展模式和早期心功能不全的轨迹，利用以下因素的联合作用区分西班牙裔成年人患心力衰竭的可能性；通过更新颖的回声测量（LV 应变和扭曲）对心脏结构和收缩/舒张功能进行常规评估将有助于筛选和识别心力衰竭风险最大的西班牙裔人，然后可以针对侵袭性危险因素进行定位。控制以减轻这一弱势群体的临床心力衰竭负担。