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（由适用提供）：2型糖尿病（T2DM）患者的冠状动脉疾病（CAD）几乎导致死亡的60％。亚临床CAD可能会在很长一段时间内“默默地”进展，直到冠状动脉事件（归因于心肌缺血的一组症状，打击T2DM患者。受侵入性，X射线暴露和肾毒性对比介质的限制，当前的诊断方法不足以估计亚临床的严重程度 T2DM患者的CAD没有记录或怀疑的心血管疾病。在过去的十年中，磁共振成像（MRI）已成为量化重塑冠状壁的形态和功能变化的承诺无创方法，该方法传达了冠状动脉事件的风险。最近的研究还提供了MRI可以评估心肌组织结构（纤维化和水肿）和心室运动/功能的变化的证据。根据技术的进步，我们假设亚临床CAD和相关心肌异常的MRI衍生特征有可能用作T2DM病理生理情况下呈现心血管风险的定量成像生物标志物。在此提案中，我们将建立一种新型的60分钟MRI方案，以描述亚临床CAD的患病率和程度，并在患有和不具有糖尿病性肾病（DN）的T2DM患者中，心脏中心的伴随结构 - 触发性变化。 DN是近40％T2DM患者发生的常见最终器官损伤，被认为是冠状动脉事件的独立预测指标。然后，我们将将冠状动脉/心脏测量值与血液和尿液中的T2DM/DN生物标志物联系起来。这些研究将进行初步测试，以指示这些MRI衍生的特征的潜在临床价值，以表明心血管预防和T2DM方案中靶向器官保护的有效性。这项指导的研究将促进我的近期目标，即通过运用我以前的工作中获得的经验和知识来扩展我在筛选定量成像生物标志物方面的专业知识，以解决使用定量MRI的T2DM患者未满足的临床需求。该项目还符合我的长期职业目标，即通过发起一项临床研究来估计T2DM人群中心血管风险，成为心血管医学的独立研究者。利用西北大学Feinberg医学院（NU/FSM）的独特研究环境和世界一流的教育机会，我将在临床心血管研究中接受深入的培训和结构化教程，包括在高级心血管成像和糖尿病生物标志物识别/测试中进行的动作培训；流行病学和生物统计学的课程工作；以及研究的半手会议和科学会议，以实现我的职业目标。