Patterns of Cardiopulmonary health across the life course

整个生命过程中心肺健康的模式

基本信息

批准号：
10634635
负责人：
Sadiya Sana Khan
金额：
$ 67.79万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10634635
关键词：
Adult Affect Age Age of Onset Air Pollution Ancillary Study Biological Assay Biological Markers Biological Process Black race Cardiac Cardiac health Cardiopulmonary Cardiovascular system Cause of Death Chronic lung disease Clinical Coronary Artery Risk Development in Young Adults Study Data Detection Disease EFRAC Echocardiography Elderly Epidemiology Event Evolution Four-dimensional Functional disorder Goals Health Health Transition Heart Heart Diseases Heart failure Image Impairment Individual Inflammation Inflammatory Intervention Joints Left Left ventricular structure Life Life Cycle Stages Link Lung Lung diseases Magnetic Resonance Imaging Measures Mechanics Mediating Mediator Morbidity - disease rate Multimodal Imaging National Heart, Lung, and Blood Institute Outcome Study Participant Pathway interactions Pattern Phenotype Predisposition Prevention Prevention strategy Proteomics Public Health Pulmonary Emphysema Pulmonary Heart Disease Pulmonary Hypertension Race Research Respiratory Tract Infections Risk Risk Factors Risk Marker Scanning Sex Differences Spirometry Strategic vision Structure Symptoms Systems Biology Testing Time Tobacco Tobacco use United States Ventricular Ventricular End-Diastolic Volumes Viral Respiratory Tract Infection Work X-Ray Computed Tomography advanced disease blood-based biomarker cardiac magnetic resonance imaging clinically relevant comorbidity critical period design disorder prevention health care service utilization hemodynamics imaging study lung health lung injury middle age mortality multidisciplinary novel phenotypic data pulmonary function resilience risk sharing screening theories tobacco exposure young adult

项目摘要

ABSTRACT Chronic lung disease and heart failure (HF) are highly prevalent, commonly co-occur, and are associated with significant morbidity and mortality. Work from our group and others has demonstrated an independent relationship between chronic lung disease and incident HF that may be driven in part by inflammation. We have also documented that even in the absence of symptomatic lung disease, impaired lung function defined by spirometry is associated with adverse cardiac remodeling on echocardiography and incident HF events. While symptomatic lung disease and HF often occur in the elderly, many younger adults have relatively asymptomatic impairment in lung health and cardiac structure and function. These subclinical cardiopulmonary abnormalities develop during the key modifiable period from young adulthood to midlife. However, data are sparse on the timing and associated mechanisms of the transition from health to disease spanning young adulthood to midlife, and related race-sex differences. Without identifying these unique patterns of change, it will not be possible to screen for subclinical changes and employ prevention strategies prior to irreversible damage in the lung and heart. This requires upstream identification at the earliest detectable change. While spirometry is the gold standard for lung disease detection, it is a relatively crude and insensitive measure of impaired lung health. In contrast, lung injury (quantified using a novel local histogram analysis developed and validated by our group) from computed tomography (CT) scans is a more sensitive and earlier indicator of impaired lung health (e.g. due to tobacco, air pollution, and respiratory viral infection). Therefore, we now propose to take advantage of the Coronary Artery Risk Development in Young Adults (CARDIA) study’s unique platform to study the temporal relationship of and mechanisms underlying the transition from lung and heart health to disease. To-date, our group has investigated the predictors and consequences of impaired lung health and HF, separately, in CARDIA. In this project, we will build upon our prior work by analyzing CT scans to determine the concurrent evolution of lung injury and adverse cardiac remodeling and identify mechanisms by assaying a multitude of blood-based biomarkers (using a multiplexed array) and performing 4-dimensional flow cardiovascular magnetic resonance imaging (cMRI). We will test the hypothesis that detailed imaging and blood-based markers can inform clinically relevant endotypes reflecting dynamic changes in lung injury and adverse cardiac remodeling during a key vulnerable period of life through the following specific aims: (1) Determine the longitudinal association between lung injury and left ventricular end-diastolic volume (LVEDV); (2) Determine the risk of subclinical and clinical HF among joint lung injury and LVEDV trajectory groups; and (3) Determine the hemodynamic mediators of the association between lung injury and adverse cardiac remodeling. This study will investigate factors associated with transitions from cardiopulmonary health to disease and associated mechanisms, and in doing so, will identify screening strategies and contribute novel pathways for targeted disease interception of lung and heart disease.

抽象的慢性肺病和心力衰竭（HF）非常普遍，通常同时发生，并且与我们小组和其他人的工作已经证明了显着的发病率和死亡率。慢性肺病与心衰之间的关系可能部分是由炎症引起的。还记录到，即使没有症状性肺部疾病，肺功能受损也定义为肺活量测定与超声心动图不良心脏重塑和心力衰竭事件相关。有症状的肺部疾病和心力衰竭常发生在老年人身上，许多年轻人相对无症状肺部健康以及心脏结构和功能受损。这些亚临床心肺异常。然而，关于这一点的数据却很少。从青年期到中年从健康到疾病的转变的时间和相关机制，如果不识别这些独特的变化模式，就不可能筛查亚临床变化并在肺部和肺部发生不可逆损伤之前采取预防策略这需要在最早可检测到的变化时进行上游识别，而肺量测定法是黄金。作为肺部疾病检测的标准，它是对肺部健康受损的相对粗糙且不敏感的衡量标准。相比之下，肺损伤（使用我们小组开发和验证的新型局部直方图分析进行量化）计算机断层扫描 (CT) 扫描是肺部健康受损的更敏感且更早的指标（例如，肺部健康受损）。烟草、空气污染和呼吸道病毒感染）因此，我们现在建议利用这一机会。年轻人冠状动脉风险发展 (CARDIA) 研究的独特平台来研究时间从肺和心脏健康到疾病的转变的关系和机制。研究小组在 CARDIA 中分别研究了肺部健康受损和心力衰竭的预测因素和后果。在这个项目中，我们将在之前的工作基础上通过分析 CT 扫描来确定肺损伤和不良心脏重塑，并通过检测多种血液来确定机制生物标志物（使用多重阵列）并执行 4 维流心血管磁共振我们将检验详细成像和基于血液的标记物可以为临床提供信息的假设。反映关键时期肺损伤和不良心脏重塑动态变化的相关内型通过以下具体目标确定生命的脆弱期： (1) 确定生命脆弱期之间的纵向关联肺损伤和左心室舒张末期容积（LVEDV）；（2）确定亚临床和临床心力衰竭的风险；关节肺损伤和 LVEDV 轨迹组之间的差异；以及 (3) 确定各组的血流动力学介质肺损伤与不良心脏重塑之间的关联本研究将调查相关因素。从心肺健康到疾病及相关机制的转变，在此过程中，将确定筛选策略并为有针对性地拦截肺病和心脏病提供新的途径。

项目成果

期刊论文数量（14）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Geographic Differences in Prepregnancy Cardiometabolic Health in the United States, 2016 Through 2019.

2016 年至 2019 年美国孕前心脏代谢健康的地理差异。

DOI：
发表时间：
2022-02-15
期刊：
影响因子：
37.8
作者：
Cameron, Natalie A;Freaney, Priya M;Wang, Michael C;Perak, Amanda M;Dolan, Brigid M;O'Brien, Matthew J;Tandon, S Darius;Davis, Matthew M;Grobman, William A;Allen, Norrina B;Greenland, Philip;Lloyd;Khan, Sadiya S
通讯作者：
Khan, Sadiya S

Leveraging Mammography as a Unique Opportunity for Cardiovascular Health Promotion.

利用乳房X光检查作为促进心血管健康的独特机会。

DOI：
发表时间：
2022-03
期刊：
影响因子：
0
作者：
Cameron, Natalie A;Khan, Sadiya S
通讯作者：
Khan, Sadiya S

Moving the Paradigm Forward for Prediction and Risk-Based Primary Prevention of Heart Failure in Special Populations.

推动特殊人群心力衰竭预测和基于风险的一级预防的范例。

DOI：
发表时间：
2022-05
期刊：
影响因子：
5.8
作者：
Everitt, Ian K;Trinh, Katherine V;Underberg, Daniel L;Beach, Lauren;Khan, Sadiya S
通讯作者：
Khan, Sadiya S

亚裔美国人亚群体中与高血压相关的心血管死亡率。

DOI：
发表时间：
2023-07
期刊：
影响因子：
5.5
作者：
Shah, Nilay S;Shimbo, Daichi;Muntner, Paul;Huffman, Mark D;Kandula, Namratha R;Mefford, Matthew T;Lloyd;Khan, Sadiya S
通讯作者：
Khan, Sadiya S

Rural-Urban Trends for Aortic Stenosis Mortality in the United States, 2008-2019.

2008-2019 年美国主动脉瓣狭窄死亡率的城乡趋势。