Epidemiology of Cardiac Structure and Function in African Caribbeans: The Tobago Heart Study

非洲加勒比地区心脏结构和功能的流行病学：多巴哥心脏研究

基本信息

批准号：
10054935
负责人：
Allison L Kuipers
金额：
$ 50.03万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-15 至 2025-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10054935
关键词：
African African American African Caribbean Behavior Biological Assay Biological Markers Biological Process Biology Blood Blood Pressure Blood Vessels Body fat Cardiac Cardiac health Cardiovascular Diseases Cardiovascular system Caribbean region Clinical Research Cost Analysis Creatinine Data Demography Diet EFRAC Echocardiography Endothelin-1 Epidemiology Family Fibrosis Fostering Functional disorder Funding Future General Population Geographic Locations Health Heart Heart Abnormalities Heart Atrium Heart Diseases Heart failure Hypertension IL6 gene Immigrant Individual Inflammation Injury to Kidney Lead Left Left Ventricular Hypertrophy Left Ventricular Mass Life Life Style Measures Medical History Morbidity - disease rate Myocardial Myocardial dysfunction Myocardium Neurosecretory Systems Obesity Participant Phenotype Physical activity Physiologic pulse Population Population Study Prevalence Prevention Publishing Recording of previous events Research Risk Risk Factors Smoking Stretching Structural defect Structure Tobago Ultrasonography Vascular Diseases Woman aged base cardiometabolic risk cardiometabolism cardiovascular health cohort comorbidity data archive demographics design epidemiology study high risk improved indexing insight men molecular marker mortality myocardial injury novel population based post gamma-globulins pro-brain natriuretic peptide (1-76)response

项目摘要

PROJECT SUMMARY Abnormalities in cardiac structure and function, such as left ventricular hypertrophy (LVH) and reduced ejection fraction (EF), are associated with increased risk of heart failure (HF) and other cardiovascular morbidity and mortality. Echocardiography provides an in-depth and low-cost assessment of multiple aspects of cardiac structure and function. Both clinical and epidemiologic studies have demonstrated that African Americans are at higher risk for hypertensive related cardiac abnormalities than Whites; however, there have been no population-based studies to assess cardiac structure and function in African Caribbeans. Risk factors for cardiac dysfunction, such as hypertension and obesity, are more common in African Caribbeans than African Americans, suggesting that African Caribbeans may have even greater cardiac dysfunction than African Americans. Over the past 20 years, we have been studying population-based cohorts of African Caribbean men and women from Tobago in whom we have extensive measures of medical history, blood pressure, subclinical cardiovascular measures, adiposity distribution, and biospecimens. We noted an exceptionally high rate of uncontrolled hypertension and elevated blood pressure in Tobago men and women, which puts them at high-risk for further CVD comorbidities. We have strong evidence that these participants have a high burden of non-atherosclerotic vascular disease; however, to this point, we have not assessed cardiac muscle health, which is a major limitation in comparing them to African American or White U.S. epidemiologic cohorts. Therefore, we propose to expand our cardiovascular research in Tobago by performing an echocardiography exam in participants aged 50 and older from the Tobago Men’s Study and the Tobago Women’s Study (N=500 each, 1000 total: The Tobago Heart Study [THS]), in order to describe the burden of and identify risk factors for cardiac dysfunction and structural abnormalities in African Caribbeans. Specifically, we aim to 1) characterize and describe the cardiac structure and function of the THS; 2) use the wealth of existing data in the Tobago Men and Women’s Studies to identify traditional and unique correlates of cardiac structure and function in African Caribbeans, including measures of demography, medical history, behaviors/lifestyle, adiposity distribution, and subclinical cardiovascular disease; and 3) comprehensively assay circulating cardiac biomarkers to identify which facets of cardiac biology are most strongly associated with cardiac structure and function measures in African Caribbeans. Completion of these Specific Aims will provide the first assessment of cardiac structure and function in African Caribbean men and women, add to the existing cardiovascular assessments in the Tobago studies, and allow for future comparison to U.S.-based CVD cohorts that include African Americans. Importantly, this will yield unique insight into the underlying biologic process(es) associated with cardiac structure and function in Tobago, which can be harnessed in future efforts to improve prediction, prevention, and treatment of cardiac disease in these high-risk individuals.

项目概要心脏结构和功能异常，例如左心室肥厚 (LVH) 和射血减少分数（EF），与心力衰竭（HF）和其他心血管疾病发病风险增加相关超声心动图提供了对心脏多个方面的深入且低成本的评估。结构和功能。临床和流行病学研究都表明非裔美国人是与白人相比，患高血压相关心脏异常的风险更高；评估非洲加勒比地区心脏结构和功能的人群研究。心脏功能障碍，如高血压和肥胖，在非洲加勒比地区比非洲人更常见美国人认为，非洲加勒比人的心脏功能障碍可能比非洲人更严重过去 20 年来，我们一直在研究非洲加勒比地区的人口群体。我们对来自多巴哥的男性和女性进行了广泛的病史、血压、我们注意到亚临床心血管测量、肥胖分布和生物样本异常高。多巴哥男性和女性未受控制的高血压和血压升高的比率，这使他们处于我们有强有力的证据表明这些参与者有很高的心血管疾病负担。非动脉粥样硬化性血管疾病；然而，到目前为止，我们尚未评估心肌健康状况，这是将他们与非裔美国人或美国白人流行病学队列进行比较的一个主要限制。因此，我们建议通过进行超声心动图检查来扩大我们在多巴哥的心血管研究多巴哥男性研究和多巴哥女性研究中 50 岁及以上参与者的考试（N=500）每个，总共 1000：多巴哥心脏研究 [THS]），以描述负担并确定风险因素具体来说，我们的目标是 1) 描述非洲加勒比地区的心脏功能障碍和结构异常。并描述 THS 的心脏结构和功能；2) 使用多巴哥现有的丰富数据男性和女性研究，以确定心脏结构和功能的传统和独特的相关性非洲加勒比地区，包括人口统计、病史、行为/生活方式、肥胖程度的衡量标准分布和亚临床心血管疾病；3) 全面循环心脏疾病生物标志物来识别心脏生物学的哪些方面与心脏结构最密切相关非洲加勒比地区的功能措施的完成将提供第一个评估。非洲加勒比男性和女性的心脏结构和功能，增加了现有的心血管多巴哥研究中的评估，并允许未来与美国的 CVD 队列进行比较，其中包括重要的是，这将对非洲裔美国人产生对相关潜在生物过程的独特见解。了解多巴哥的心脏结构和功能，可以在未来的努力中利用它来改进预测，预防和治疗这些高危人群的心脏病。