Is Preeclampsia and Spontaneous Preterm Delivery Associated with Vascular and Cardiac Function?

先兆子痫和自然早产与血管和心脏功能有关吗？

• 批准号: 10005487
• 负责人: Margo Minissian
• 金额: $ 9.29万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10005487
• 关键词: Address; Aorta; Atherosclerosis; Award; Biological Markers; Blood Circulation; Blood Vessels; Cardiac; Cardiovascular Physiology; Cause of Death; Cessation of life; Chronic; Clinical; Collection; Data; Data Set; Development; Diabetes Mellitus; Disease; Disease Pathway; Doctor of Philosophy; Fibrosis; Future; Goals; Heart failure; Hour; Hyperlipidemia; Hypertension; Imaging Techniques; Individual; Intervention; Lead; Left; Left Ventricular Dysfunction; Link; Lipids; Longitudinal Studies; Magnetic Resonance Imaging; Malignant Neoplasms; Matrix Metalloproteinases; Measures; Mentors; Metalloproteases; Mothers; Muscle Tonus; Myocardial dysfunction; National Institute of Nursing Research; Nurses; Outcomes Research; Pathway interactions; Perinatal; Phenotype; Physiologic pulse; Physiology; Placenta Diseases; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Premature Birth; Proteins; Proteomics; Publications; Recording of previous events; Reporting; Research; Research Design; Research Personnel; Risk; Risk Factors; Science; Scientific Advances and Accomplishments; Scientist; Severities; Shapes; Structure; Symptoms; Testing; Time; Tissues; Training; Transforming Growth Factors; Translating; Vascular Diseases; Vascular Smooth Muscle; Vasodilation; Ventricular; Woman; Women' s Health; adverse outcome; adverse pregnancy outcome; arterial stiffness; atherosclerosis risk; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular nursing; comparative; coronary fibrosis; epidemiology study; experience; follow-up; heart function; indexing; innovation; insight; multidisciplinary; novel; outcome prediction; patient oriented research; pre-clinical; response; retention rate; symptom science; translational scientist; vasoconstriction

ABSTRACT The broad, long term objective of this award is to facilitate independence as a nurse scientist, generate preliminary evidence and facilitate an R01 application. The overarching goal of this study is to compare vascular function, cardiac structure and function and lipid biomarker/fibrosis proteomics between each adverse pregnancy group to gain insight into mechanisms leading to adverse outcomes and provide opportunities for intervention. The proposed study, “Is Preeclampsia and Spontaneous Preterm Delivery Associated with Vascular and Cardiac Dysfunction?” is a longitudinal, comparative design study, were I will compare 4 groups; 1) women who experience term preeclampsia (≥37 weeks); 2) spontaneous preterm delivery (sPTD) (≤ 34 weeks) and; 3) preterm preeclampsia (PreE) (<37 weeks) compared to women who experience 4) full-term deliveries (≥39 weeks) at 3-time points (24-72 hours, 1 and 2 years postpartum). My long-term goals are to: (1) employ comprehensive mechanistic phenotyping and utilizing cardiac magnetic resonance imaging (CMRI) techniques to refine the current understanding of mechanisms linking adverse pregnancy outcomes (APOs) and atherosclerotic cardiovascular disease (ASCVD) risk; (2) translate scientific advances across cardiovascular, nursing science, proteomics and women’s health research in order to elucidate how we further phenotype APOs (3) enhance our ability to identify individuals at risk for future ASCVD early in the course of ASCVD, before the onset of clinical disease; (4) ultimately change ASCVD disease course for women who are at increased risk (5) lead a multidisciplinary team of translational investigators focused on the research. The following key variables related to future risk of cardiovascular disease will be evaluated: vascular function (augmentation index and pulse wave velocity) and cardiac structure and function measured by cardiac magnetic resonance imaging utilizing Cine, Tissue Tagging (left ventricular systolic and diastolic function including strain), T1 mapping (fibrosis), at 1 and 2 years postpartum.) Secondary measures include novel cardiac biomarkers including a lipid biomarker collection for 72 proteins and lipids, proteomics fibrosis panel [(Matric metalloproteinases (MMPs) and Transforming Growth Factor-β1 (TGF-"β1). Ultimately, the outcome of this research will inform relationships between TPre, sPTD and PreE which is an important step to uncover the link between APOs and future maternal ASCVD risk. This effort will shape the development of specific treatment targets for new opportunities in chronic ASCVD prevention. Achieved training goals will augment and facilitate independence, generate preliminary evidence and facilitate an R01 application.

抽象的 该奖项的广泛、长期目标是促进护士科学家的独立性，产生 初步证据并促进 R01 应用 本研究的总体目标是比较血管。 每次不良妊娠之间的功能、心脏结构和功能以及脂质生物标志物/纤维化蛋白质组学 小组深入了解导致不良结果的机制并提供干预机会。 拟议的研究“先兆子痫和自发性早产是否与血管和神经系统相关” 心脏功能障碍？”是一项纵向比较设计研究，我将比较 4 组：1) 女性； 患有足月先兆子痫（≥37 周）；2) 自发性早产 (sPTD)（≤ 34 周）； 与经历 4) 足月分娩（≥39 周）的女性相比，早产先兆子痫 (PreE)（<37 周） 周）分 3 个时间点（24-72 小时、产后 1 年和 2 年）。我的长期目标是：(1) 雇用。 综合机械表型分析和利用心脏磁共振成像 (CMRI) 技术 完善目前对不良妊娠结局（APO）和 动脉粥样硬化性心血管疾病 (ASCVD) 风险；(2) 将科学进步转化为心血管、 护理科学、蛋白质组学和女性健康研究，以阐明我们如何进一步确定 APO 表型 (3) 增强我们在 ASCVD 病程早期、在疾病发生之前识别未来有 ASCVD 风险的个体的能力 临床疾病的发作；(4) 最终改变高风险女性的 ASCVD 病程 (5) 领导一个由转化研究人员组成的多学科团队专注于这项研究。 将评估与未来心血管疾病风险相关的以下关键变量： 血管功能 （增强指数和脉搏波速度）以及通过心脏测量测量的心脏结构和功能 利用电影、组织标记的磁共振成像（左心室收缩和舒张功能 包括应变）、T1 绘图（纤维化），产后 1 年和 2 年。）次要测量包括新的 心脏生物标志物，包括 72 种蛋白质和脂质的脂质生物标志物集合、蛋白质组学纤维化小组 [（基质金属蛋白酶（MMP）和转化生长因子-β1（TGF-“β1）”。最终，结果 这项研究将揭示 TPre、sPTD 和 PreE 之间的关系，这是揭示 TPre、sPTD 和 PreE 之间的关系的重要一步 APO 与未来孕产妇 ASCVD 风险之间的联系这一努力将影响特定治疗的发展。 慢性 ASCVD 预防新机会的目标 已实现的培训目标将增强和促进。 独立性，生成初步证据并促进 R01 申请。