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.

项目摘要心脏结构和功能异常，例如左心室肥大（LVH）和射血降低分数（EF）与心力衰竭（HF）和其他心血管发病率的增加有关死亡。超声心动图提供了对心脏多个方面的深入和低成本评估结构和功能。临床和流行病学研究都表明非洲裔美国人是高血压相关心脏异常的风险高于白人；但是，没有基于人群的研究，以评估非洲加勒比海的心脏结构和功能。风险因素心脏功能障碍，例如高血压和肥胖，在非洲加勒比海地区比非洲更常见美国人，表明非洲加勒比人的心脏功能障碍可能比非洲更大美国人。在过去的20年中，我们一直在研究基于人群的非洲加勒比海人群来自多巴哥的男人和女人，我们对病史，血压，血压，亚临床心血管措施，肥胖分布和生物测量。我们注意到一个异常高的多巴哥男性和女性的不受控制的高血压和血压升高的率，这使他们处于高风险以进一步的CVD合并症。我们有强有力的证据表明这些参与者的负担很高非动脉粥样硬化血管疾病；但是，至此，我们尚未评估心肌健康，这是将它们与非裔美国人或美国白人流行病学人群进行比较的主要限制。因此，我们建议通过超声心动图扩大多巴哥的心血管研究来自Tobago男子研究和Tobago妇女研究的50岁及以上参与者的考试（n = 500 每个，总计1000：Tobago心脏研究[THS]），以描述燃烧并确定风险因素非洲加勒比海地区的心脏功能障碍和结构异常。具体来说，我们的目的是1）表征并描述THS的心脏结构和功能； 2）在多巴哥使用现有数据的财富男女研究以识别心脏结构和功能的传统和独特相关性非洲加勒比人，包括衡量障碍，病史，行为/生活方式，肥胖的测量分布和亚临床心血管疾病； 3）全面测定循环心脏生物标志物识别哪些心脏生物学方面与心脏结构和心脏结构最密切相关非洲加勒比海的功能度量。这些特定目标的完成将提供首次评估非洲加勒比男性和女人的心脏结构和功能，增加现有的心血管多巴哥研究的评估，并允许将来与美国的CVD队列进行比较非裔美国人。重要的是，这将产生对相关的潜在生物学过程（ES）的独特见解通过在多巴哥进行心脏结构和功能，这可以在未来改善预测的努力方面利用，预防和对这些高风险个体的心脏疾病的治疗。