Quantitative MRI for the assessment of subclinical CAD in T2DM

定量 MRI 评估 T2DM 亚临床 CAD

• 批准号: 9307576
• 负责人: Kai Lin
• 金额: $ 16.61万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9307576
• 关键词: Address; Arterial Fatty Streak; Award; Biological Markers; Biometry; Blood; Blood Glucose; C-reactive protein; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Characteristics; Clinical; Clinical Research; Contrast Media; Coronary; Coronary Arteriosclerosis; Coronary artery; Coupled; Development; Diabetes Mellitus; Diabetic Nephropathy; Diagnostic Procedure; Edema; Employee Strikes; Environment; Epidemiology; Event; Fibrosis; Future; Goals; Heart; High Density Lipoproteins; Hyperglycemia; Hypertension; Impairment; Individual; Inflammatory; Intervention; Investigation; Knowledge; Link; Lipids; Low-Density Lipoproteins; MRI Scans; Magnetic Resonance Imaging; Masks; Measurement; Medicine; Mentors; Mentorship; Metabolic Pathway; Methods; MicroRNAs; Modification; Morphology; Motion; Myocardial; Myocardial Ischemia; Myocardial tissue; Nephrotoxic; Non-Insulin-Dependent Diabetes Mellitus; Organ; Outcome; Pathologic; Patients; Population; Prevalence; Prevention; Proteins; Protocols documentation; Regimen; Research; Research Personnel; Research Project Grants; Risk; Roentgen Rays; Scheme; Severities; Source; Standardization; Structure; Symptoms; Testing; Therapeutic; Thick; Time; Training; Universities; Urine; Vascular remodeling; Ventricular; Work; base; biomarker identification; blood pressure regulation; body system; cardiovascular imaging; cardiovascular risk factor; career; diabetic; experience; imaging biomarker; indexing; lipid disorder; medical schools; meetings; nephrotoxicity; novel; personalized medicine; prospective; public health relevance; quantitative imaging; response; screening; skills; standard care

 DESCRIPTION (provided by applicant): Coronary artery disease (CAD) causes nearly 60% of deaths in patients with type 2 diabetes mellitus (T2DM). Subclinical CAD may "silently" progress over a long time period until coronary events, a group of symptoms attributed to myocardial ischemia, strike T2DM patients. Limited by invasiveness, X-ray exposure and nephrotoxic contrast media, current diagnostic methods are insufficient to estimate the severity of subclinical CAD in T2DM patients without documented or suspected cardiovascular diseases. Over the past decade, magnetic resonance imaging (MRI) has emerged as a promising noninvasive method for quantifying morphological and functional changes of remodeled coronary wall, which convey the risk of coronary events. Recent studies also provide evidence that MRI can evaluate changes in myocardial tissue structure (fibrosis and edema) and ventricular motion/function. Based on the technical advances, we hypothesize that MRI-derived characteristics of subclinical CAD and related myocardial abnormalities have the potential to serve as quantitative imaging biomarkers presenting the cardiovascular risk under pathophysiological circumstances of T2DM. In this proposal, we will build a novel 60-minute MRI protocol to delineate the prevalence and extent of subclinical CAD coupled with concomitant structure-function changes of the heart in T2DM patients with and without diabetic nephropathy (DN). DN is a common end-organ damage occurs in nearly 40% T2DM patients and has been considered as an independent predictor of coronary events. Then, we will link coronary/cardiac measurements to T2DM/DN biomarkers in the blood and urine. These investigations will be performed to preliminary test the potential clinical value of these MRI-derived signatures for indicating the efficacy of cardiovascular prevention and target-organ protection in T2DM regimens. The mentored research will facilitate my immediate goal of expanding my expertise in screening quantitative imaging biomarkers by applying the experience and knowledge acquired in my previous work to address unmet clinical needs for T2DM patients using quantitative MRI. The project also fits my long-term career goal of becoming an independent investigator in cardiovascular medicine by launching a clinical study for the estimation of cardiovascular risk in T2DM population. Taking advantage of the unique research environments and world-class educational opportunities at Northwestern University Feinberg School of Medicine (NU/FSM), I will receive intensive training and structured tutorials in clinical cardiovascular research, including hands-on training in advanced cardiovascular imaging and diabetic biomarker identification/testing; course work in epidemiology and biostatistics; and research seminars and scientific meetings, to achieve my career goals.

 描述（由申请人提供）： 2 型糖尿病 (T2DM) 患者中近 60% 的死亡是由冠状动脉疾病 (CAD) 造成的。亚临床 CAD 可能会在很长一段时间内“悄无声息”地进展，直至出现冠状动脉事件（一组症状）。由于心肌缺血，T2DM 患者受到侵袭性、X 射线暴露和肾毒性造影剂的限制，目前的诊断方法不足以估计其严重程度。亚临床的 在过去的十年中，磁共振成像 (MRI) 已成为一种有前途的无创方法，可用于量化重塑冠状动脉壁的形态和功能变化，从而揭示冠状动脉事件的风险。还提供证据表明 MRI 可以评估心肌组织结构（纤维化和水肿）和心室运动/功能的变化。基于技术进步，我们研究了亚临床 CAD 和相关心肌的 MRI 衍生特征。异常有可能作为影像生物标志物，在 T2DM 病理生理情况下呈现心血管风险。在这个定量提案中，我们将建立一个新颖的 60 分钟 MRI 协议来描述亚临床 CAD 的患病率和程度以及伴随的结构功能变化。患有或不患有糖尿病肾病 (DN) 的 T2DM 患者的心脏损伤是近 40% T2DM 患者中常见的终末器官损害，并且被认为是一种常见的终末器官损害。然后，我们将冠状动脉/心脏测量与血液和尿液中的 T2DM/DN 生物标志物联系起来，以初步测试这些 MRI 衍生特征的潜在临床价值，以指示心血管的功效。这项指导研究将有助于我的近期目标，即通过应用我之前工作中获得的经验和知识来扩展我在筛选成像定量生物标志物方面的专业知识，以利用定量 MRI 解决 T2DM 患者未满足的临床需求。该项目还利用西北大学范伯格医学院独特的研究环境和世界一流的教育机会，开展一项评估 T2DM 人群心血管风险的临床研究，符合我成为心血管医学独立研究者的长期职业目标。 （NU/FSM），我将接受临床心血管研究的强化培训和结构化教程，包括高级心血管成像和糖尿病生物标志物识别/测试的实践培训以及流行病学和生物统计学以及研究研讨会和科学会议；实现我的职业目标。