The Vascular, Autonomic, and Myocardial Phenotypes in Women with Myocardial Infarction due to Spontaneous Coronary Artery Dissection

自发性冠状动脉夹层导致女性心肌梗塞的血管、自主神经和心肌表型

• 批准号: 10473548
• 负责人: Marysia S Tweet
• 金额: $ 16.09万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10473548
• 关键词: Acceleration; Adverse event; Advisory Committees; Affect; Age; Aging; Aneurysm; Aorta; Aptitude; Arteries; Baroreflex; Biological Markers; Biometry; Blood Vessels; Blood flow; Cardiovascular Diseases; Caring; Chest Pain; Cholesterol; Clinic; Clinical; Clinical Data; Clinical Investigator; Clinical Research; Collagen; Computerized Medical Record; Coronary; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Data; Data Analyses; Deposition; Diabetes Mellitus; Diagnosis; Disease; Dissection; Dobutamine; Echocardiography; Elastin; Electronics; Endothelium; Environment; Etiology; Exercise; Female; Fibromuscular Dysplasia; Functional disorder; Future; Goals; Grant; Hand; Hemorrhage; Hyperlipidemia; Hypertension; Image; Individual; Institution; Interdisciplinary Study; International; Isometric Exercise; Knowledge; Lead; Leadership; Link; Manuscripts; Measurement; Mechanics; Medial; Mentors; Mentorship; Mission; Multimodal Imaging; Muscle; Myocardial; Myocardial Infarction; Myocardial perfusion; National Heart, Lung, and Blood Institute; Nerve; Outcome; Outcome Measure; Patients; Perfusion; Peripheral; Phenotype; Physicians; Physiologic pulse; Physiology; Pregnancy; Pregnant Women; Preparation; Process; Prospective Studies; Psyche structure; Recording of previous events; Recurrence; Registries; Regulation; Research; Research Design; Research Technics; Rest; Risk Factors; Science; Scientist; Severities; Standardization; Strategic vision; Stress; Stress Tests; Structure; Surveys; Testing; Thick; Tobacco use; Training; United States National Institutes of Health; Valsalva Maneuver; Woman; Women' s Health; Work; Writing; acute coronary syndrome; arterial tortuosity; cardiovascular disorder risk; career; career development; disorder risk; endothelial dysfunction; experience; grasp; healing; health training; hemodynamics; improved; improved outcome; indexing; insight; interest; myocardial injury; neurovascular; next generation; patient population; patient subsets; prospective; reproductive; research study; response; shear stress; skills; stressor; vascular abnormality

PROJECT DESCRIPTION/ABSTRACT Candidate: Dr. Tweet’s long-term goal is to become an independent clinical investigator in the field of coronary artery disease in women. Her short-term goal is to explore the vascular, autonomic and microvascular phenotypes in women with a history of spontaneous coronary artery dissection (SCAD). To achieve these goals, Dr. Tweet will: 1) acquire the expertise required for her scientific aims; 2) improve her data analysis skills via coursework and biostatistical support; 3) develop scientific leadership skills and collaborative relationships to move this field forward. Environment: The Mayo Clinic SCAD Registry is the largest international SCAD registry. Dr. Tweet’s primary mentor, Dr. Joyner and her Career Advisory Committee have the expertise and mentorship qualities to guide Dr. Tweet’s career development as a physician-scientist. Background: SCAD is a leading cause of nonatheroembolic acute coronary syndromes in women. Most patients do not have traditional risk factors such as tobacco use, hyperlipidemia, or diabetes. Rather, peripheral arterial abnormalities such as fibromuscular dysplasia are observed in the majority of patients. SCAD is associated with stress, exercise, and pregnancy. Recurrent SCAD occurs in 10-30% of patients. Specific Aims: We will aim to assess arterial structure and mechanics (Aim #1), neurovascular function (Aim #2), and microvascular function (Aim #3) in women with SCAD. Study Design & Outcome Measures: This is a prospective study of women evaluated in the Mayo Clinic SCAD Clinic. Measurements will include arterial thickness and stiffness, sympathetic baroreflex sensitivity and autonomic responses to sympathoexcitatory to standardized stressors, and myocardial perfusion echocardiography with dobutamine stress. Relationship to Career Goals of the Candidate: The projects in the application will be instrumental for the candidate’s career development by facilitating: scientific management and leadership skills, acquisition of new research techniques, and generating interdisciplinary and multi-institutional collaborative alliances. Thus it is the next logical step in her research career progression. Relationship to the NHLBI Mission: The proposed project is consistent with the NHLBI strategic vision for understanding underlying pathophysiological mechanisms of disease and for improving study of diseases affecting women. It is consistent with the NHLBI’s interest in hypertension, sympathoexcitation and cardiovascular disease risk. It is also consistent with broader NIH goals related to training the next generation of clinical investigators.

项目描述/摘要 候选人：Tweet博士的长期目标是成为独立的临床研究者 妇女冠状动脉疾病领域。她的短期目标是探索血管 具有赞助冠状动脉史的女性的自主和微血管表型 动脉解剖（SCAD）。为了实现这些目标，Tweet博士将：1）获取专业知识 她的科学目标所必需的； 2）通过课程提高她的数据分析技能， 生物统计支持； 3）发展科学领导技能和协作关系 向前移动这个领域。环境：梅奥诊所SCAD注册表是最大的 国际SCAD注册表。 Tweet博士的主要精神，Joyner博士及其职业咨询 委员会具有指导Tweet博士职业的专业知识和心理素质 作为身体科学家的发展。背景：SCAD是主要原因 女性的非雌雄节急性冠状动脉综合征。大多数患者没有传统 烟草使用，高脂血症或糖尿病等危险因素。而是外周动脉 在大多数患者中观察到异常，例如纤维肌肉发育不良。 SCAD是 与压力，运动和怀孕有关。复发性SCAD发生在10-30％ 患者。具体目的：我们将旨在评估动脉结构和力学（AIM＃1）， SCAD女性中的神经血管功能（AIM＃2）和微血管功能（AIM＃3）。 研究设计和结果指标：这是对评估妇女的前瞻性研究 梅奥诊所SCAD诊所。测量将包括动脉厚度和刚度 对交感神经的交感敏感性和自主性反应 标准压力源和多丁胺应激的心肌灌注超声心动图。 与候选人的职业目标的关系：申请中的项目将是 通过支持：科学管理和 领导技能，新研究技术的获取以及产生跨学科和 多机构合作联盟。这是她研究职业的下一个合理步骤 进展。与NHLBI任务的关系：拟议的项目与 NHLBI了解疾病的潜在病理生理机制的战略愿景 并改善对影响女性的疾病的研究。它与NHLBI的兴趣一致 在高血压，交感神经和心血管疾病风险中。它也与 与培训下一代临床研究人员有关的更广泛的NIH目标。

项目成果

Genetic Testing in High-risk Spontaneous Coronary Artery Dissection-Searching for Clinical Utility Among Background Genetic Noise.

• DOI: 10.1001/jamacardio.2022.2978
• 发表时间: 2022-10-01
• 期刊: JAMA cardiology
• 影响因子: 24

Tale of two hearts: a TNNT2 hypertrophic cardiomyopathy case report.

• DOI: 10.3389/fcvm.2023.1167256
• 发表时间: 2023
• 期刊: FRONTIERS IN CARDIOVASCULAR MEDICINE
• 影响因子: 3.6
• 作者: Pham, Justin H.;Giudicessi, John R.;Tweet, Marysia S.;Boucher, Lauren;Newman, D. Brian;Geske, Jeffrey B.
• 通讯作者: Geske, Jeffrey B.

Health status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience.

• DOI: 10.1371/journal.pone.0265624
• 发表时间: 2022
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Murugiah K;Chen L;Dreyer RP;Bouras G;Safdar B;Khera R;Lu Y;Spatz ES;Ng VG;Gupta A;Bueno H;Tweet MS;Spertus JA;Hayes SN;Lansky A;Krumholz HM
• 通讯作者: Krumholz HM

Cardiac Injury After Acute Ischemic Stroke: Are Women at Increased Risk?

• DOI: 10.1161/jaha.123.032173
• 发表时间: 2023-11-07
• 期刊: Journal of the American Heart Association
• 影响因子: 5.4

Acute Myocardial Infarction Caused by Spontaneous Coronary Artery Dissection of the First Septal Perforator.

• DOI: 10.1016/j.jaccas.2023.101833
• 发表时间: 2023-05-17
• 期刊: JACC. Case reports
• 作者: Rezkalla, Joshua A;Lathiya, Maulik K;Araoz, Philip A;Singh, Gurpreet;Tweet, Marysia S
• 通讯作者: Tweet, Marysia S