Evaluation of Racial Differences in Cardiorespiratory Fitness Decline with Aging & Underlying Biological Mechanisms

心肺健康随年龄下降的种族差异评估

• 批准号: 10260503
• 负责人: Ambarish Pandey
• 金额: $ 16.39万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10260503
• 关键词: Adipose tissue; Adult; African American; Age; Age Factors; Age-Years; Aging; Attenuated; Biological; Blood Pressure; Body Composition; Body mass index; Cardiac; Cardiac Output; Cardiovascular system; Communities; Conflict (Psychology); Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Disease; EFRAC; Echocardiography; Elderly; Ethics; Evaluation; Exercise; Exercise Test; Future; Goals; Health Care Costs; Heart; Heart Rate; Heart failure; High Prevalence; Hypertension; Impaired cognition; Impairment; Individual; Intervention; Left Ventricular Hypertrophy; Low Prevalence; Magnetic Resonance Imaging; Measures; Mentors; Morbidity - disease rate; Muscle; Myocardial; Myocardial Infarction; Myocardial perfusion; Nested Case-Control Study; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Oxygen; Participant; Pathway interactions; Performance; Peripheral; Phenotype; Prevalence; Prevention approach; Race; Reporting; Reproducibility; Research Design; Research Personnel; Risk; Risk Factors; Series; Sex Factors; Skeletal Muscle; Stress; Stress Tests; Stroke Volume; Structure; Testing; Time; Training Programs; Visit; Work; age related; base; cardiorespiratory fitness; chronotropic; cohort; cost; design; epidemiology study; ethnic difference; exercise training; fitness; fitness test; follow-up; functional status; hemodynamics; high risk; improved; insight; middle age; mortality; multi-ethnic; muscle form; myocardial injury; novel; novel strategies; phase 2 study; phase 3 study; preservation; prevent; racial and ethnic; racial difference; racial disparity; sex; sex risk; uptake

Project Abstract: Heart failure (HF) with preserved ejection fraction (HFpEF) is common in older adults and increasing in prevalence. Furthermore, there are substantial racial disparities in the burden of HF, including HFpEF, such that African American (AA) have much higher prevalence of HF than other races. In a series of epidemiological studies, we have demonstrated that low cardiorespiratory fitness (CRF), measured as peak oxygen uptake (peak VO2) on a maximal stress test, is a strong independent predictor of higher risk of HF, particularly HFpEF, in older adults. Furthermore, CRF levels among AA are consistently lower as compared with other races. Taken together, low CRF and accelerated age-related decline in CRF may be key contributors to the racial differences in the burden of HF. A better understanding of the mechanisms underlying the racial disparities in prevalence of low CRF and age-related CRF decline is key to developing novel, effective approaches to prevention of HF in older AA adults. Accordingly, in this study, we aim to evaluate the racial differences in age-related decline in CRF and their underlying biological mechanisms. To this end, we will perform a nested case-control study within the Dallas Heart Study (DHS), a multi-ethnic cohort of community- dwelling individuals, including older AA and white adults matched for age, sex, and risk factors (BMI, systolic blood pressure, diabetes status) who underwent CRF testing in middle-age (mean age 50-55) as part of the DHS phase 2 visit (2007-09) and are participating in the DHS phase 3 10-years later (2019-2022). Participants will undergo repeat CRF assessment and comprehensive state-of-the-art phenotyping to comprehensively evaluate the potential mechanisms of racial differences in CRF, including the following: stroke volume reserve by echocardiogram, heart rate reserve, myocardial perfusion, myocardial energetics by cardiac MRI, skeletal muscle energetics assessment by 7T MRI, and regional adipose tissue by whole body MRI. Peak VO2 combined with its central and peripheral determinants will be compared among matched AA and white participants in the DHS phase 3. Successful completion of these two aims will quantify the CRF decline in AA versus white older individuals for the first time and elucidate specific mechanisms, thereby, providing critical insight into the underlying pathophysiologic mechanisms of low CRF.

项目摘要： 具有保留的射血分数（HFPEF）的心力衰竭（HF）在老年人中很常见，并且增加 流行率。此外，HF的负担包括HFPEF，例如这样的种族差异 非裔美国人（AA）的HF患病率要比其他种族高得多。在一系列流行病学中 研究，我们已经证明，低心肺适应性（CRF），以峰值吸收为峰值 （峰VO2）在最大压力测试中，是HF风险较高的强有力的独立预测指标，尤其是 HFPEF，老年人。此外，与其他 种族。综上 HF负担的种族差异。更好地理解种族基础的机制 CRF低和与年龄相关的CRF下降的差异是发展新颖，有效的关键 在年龄较大的AA成年人中预防HF的方法。因此，在这项研究中，我们旨在评估种族 CRF与年龄相关的下降及其潜在的生物学机制的差异。为此，我们将 在达拉斯心脏研究（DHS）中进行嵌套的病例对照研究，这是一个多种族的社区群体 居住的人，包括年龄较大的AA和白人成年人，适合年龄，性别和危险因素（BMI，收缩期 血压，糖尿病状态），在中年进行CRF测试（平均年龄50-55） DHS第2阶段访问（2007-09），并在10年后（2019-2022）参加了DHS第3阶段。参与者 将进行重复的CRF评估和全面的最新表型 评估CRF种族差异的潜在机制，包括以下内容：中风量储备 通过超声心动图，心率储备，心肌灌注，心肌能量学的心脏MRI，骨骼 通过7T MRI评估肌肉能量学和全身MRI的区域脂肪组织。峰值VO2 将在匹配的AA和白色中比较其中央和外围决定因素的结合 DHS第3阶段的参与者。这两个目标的成功完成将量化AA的CRF下降 与白人老年人首次相对于白人，并阐明了特定的机制，从而提供了关键 深入了解低CRF的潜在病理生理机制。