Environmental Exposures and the Development of Subclinical and Clinical Vascular and Myocardial Disease

环境暴露与亚临床和临床血管和心肌疾病的发展

• 批准号: 10622466
• 负责人: Kabayam M Venkat Narayan
• 金额: $ 10.53万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10622466
• 关键词: Accounting; Address; Adult; Air; Air Pollution; Area; Arteries; Asia; Atherosclerosis; Biological; Biological Markers; Blood Glucose; Body Weight; Calcium; Cardiomyopathies; Cardiovascular Diseases; Carotid Artery Plaques; Cessation of life; Chronic Disease; Cities; Clinical; Complex; Cross-Sectional Studies; Data; Data Analyses; Development; Disease; Echocardiography; Environmental Exposure; Environmental Risk Factor; Equipment and supply inventories; Event; Functional disorder; Funding; Health; Health Policy; Heart failure; Hybrids; Hypertension; Immune; Incidence; Income; India; Inflammation; Investigation; Knowledge; Lead; Left Ventricular Dysfunction; Link; Long-Term Effects; Maps; Measurement; Measures; Mediating; Meteorology; Methods; Myocardial Infarction; Myocardial Ischemia; National Heart, Lung, and Blood Institute; Natural History; Nitrogen Oxides; Ozone; Participant; Particulate Matter; Pathogenesis; Pathway interactions; Persons; Phenotype; Pollution; Population; Population Heterogeneity; Prevention; Production; Program Research Project Grants; Proteins; Resolution; Risk Factors; Risk Reduction; Role; Sampling; Social Environment; South Asian; Stress; Stroke; Techniques; Thick; Time; Uncertainty; United States National Institutes of Health; Vascular Diseases; advanced analytics; aged; ambient air pollution; arterial stiffness; blood pressure elevation; built environment; cardiometabolic risk; cardiovascular disorder prevention; cardiovascular disorder risk; cardiovascular effects; carotid intima-media thickness; cohort; coronary artery calcium; data management; density; disease phenotype; fine particles; follow-up; global health; high risk; improved; individualized prevention; land use; metropolitan; mortality; multiple omics; population based; predictive modeling; prospective; protein biomarkers; recruit; risk prediction; social; sociodemographics; spatiotemporal; statistical and machine learning; stem

PROJECT SUMMARY / ABSTRACT: Project 2 Environmental factors (i.e., ambient air pollution) are ubiquitous and potential causative factors in cardiovascular disease (CVD). Our preliminary studies using data from the NIH-funded GeoHealth Hub and the NHLBI-funded Center for cArdiometabolic Risk Reduction in South Asia Cohort (CARRS), indicate a strong temporal association for short- and long-term effects of ambient particulate matter (PM2.5)) exposure and elevated blood pressure and glycemic measures. Motivated by these findings, in Project 2 of Precision- CARRS, we will investigate the longitudinal association between PM2.5 and CVD subclinical and clinical CVD phenotypes (provided by the CVD Phenotyping Core). For atherosclerotic (ASCVD) and heart failure (HF) pathways. Precision-CARRS, will follow 21,864 socio-demographically diverse South Asians aged ≥20 years, representative of Delhi and Chennai, two cities with high levels of, and substantial spatio-temporal variability in, ambient air pollution. The cohort will be followed for up to 15 years, accruing 176,536 person-years and >1000 incident ASCVD (MI, stroke, CVD death) events and nearly 940 HF Stage C/D cases. PM2.5 will be assessed through a hybrid predictive model combining statistical and machine learning techniques using data from satellites, land use maps, meteorology, and emissions inventories. Our aims are: To assess the relationship between PM2.5 and: (Aim 1) Functional subclinical vascular and myocardial disease (arterial stiffness, and left ventricular dysfunction measured as either systolic and/or diastolic dysfunction using echocardiography); (Aim 2) Structural subclinical disease (artery calcium; carotid intimal media thickness, carotid plaque); (Aim 3) Clinical CVD events (i) ASCVD: incident nonfatal myocardial infarction, stroke, and CVD Death, (ii) HF: Stage C/D cases). In Aim 4, we will explore whether the pathophysiologic pathway-specific proteins measured in Project 1 (i.e., inflammation, immune dysregulation, myocardial ischemia and stress) modify the associations between PM2.5 and clinical ASCVD and HF. We will also contribute data to Project 3 to further examine the causal link between PM2.5 and CVD phenotypes using untargeted multi-omics, and Project 4 to separate social from environment influences in the production of CVD risk. We will contribute to the understanding of the connection between one of the leading adverse environmental exposures (i.e., air pollution) and CVD, to improving precision of risk prediction by accounting for environmental factors to advance precision CVD prevention, and generate data to facilitate global health policy to address air pollution.

项目摘要 /摘要：项目2 环境因素（即环境空气污染）是普遍存在的潜在灾难性因素 心血管疾病（CVD）。我们使用来自NIH资助的地卫生枢纽的数据和 NHLBI资助的南亚队列降低心脏代谢风险的中心（CARRS）表明很强 临时关联环境特定物质（PM2.5）的短期和长期影响）和 血压升高和血糖测量。由这些发现的激励，在精确的项目2中 CARR，我们将研究PM2.5和CVD亚临床和临床CVD之间的纵向关联 表型（由CVD表型核提供）。用于动脉粥样硬化（ASCVD）和心力衰竭（HF） 途径。精密 - 卡尔斯（Precision-Carrs）将遵循21,864个社会人口统计学上≥20岁的南亚人， 代表德里和钦奈，两个具有高水平和实质时空变异性的城市 环境空气污染。该队列将最多遵循15年，应计入176,536人年和> 1000 事件ASCVD（MI，Stroke，CVD死亡）事件和近940 hf阶段C/D病例。 PM2.5将被评估 通过使用来自统计和机器学习技术的混合预测模型使用来自 卫星，土地使用地图，气象学和排放清单。我们的目标是：评估关系 在PM2.5和：（ AIM 1）功能性亚临床血管和心肌疾病（动脉僵硬，左） 使用超声心动图测量的心室功能障碍是收缩期和/或舒张功能障碍）； （目的 2）结构亚临床疾病（动脉钙；颈动脉内膜培养基厚度，颈动脉斑块）； （目标3） 临床CVD事件（i）ASCVD：事件非致命心肌梗塞，中风和CVD死亡，（ii）HF：阶段 C/D病例）。在AIM 4中，我们将探讨是否在 项目1（即炎症，免疫失调，心肌缺血和压力）修改关联 在PM2.5和临床ASCVD和HF之间。我们还将为项目3贡献数据，以进一步检查 使用不靶向的多词和项目4之间的PM2.5和CVD表型之间的因果关系，以分开社交 来自环境影响CVD风险的产生。我们将为理解 领先的不利环境暴露（即空气污染）和CVD之间的联系， 通过考虑环境因素来提高精度CVD来提高风险预测的精度 预防，并生成数据以促进全球卫生政策以应对空气污染。