Impairment of coronary vasofunction is believed to be one of the earliest manifestations of coronary heart disease (CHD). The impact of risk factors such as elevated cholesterol levels, diabetes, hypertension, and smoking on the coronary microcirculation remains largely unknown. Our major objective is to investigate in a cross-sectional study whether an impairment of the myocardial perfusion reserve provides a marker of CHD by comparing it to other novel measures of subclinical vascular disease, and by testing its association with risk factors for CHD. The proposed study is ancillary to the Multi-Ethnic Study of Atherosclerosis (""""""""MESA""""""""), which is an NHLBI funded, prospective observational study of the characteristics of subclinical cardiovascular disease, i.e. disease detected non-invasively before it has produced signs and symptoms. In MESA new measures of subclinical disease such as coronary artery calcium and impaired brachial artery reactivity are to be examined to investigate their relationships to well-established risk factors and clinical events. We believe that myocardial perfusion reserve (MPR)is a useful measure of coronary vasofunction that should be included in an evaluation of new measures of subclinical disease. An impaired MPR appears to be a specific early indicator of the functional impairment of the microcirculation in patients with risk factors for coronary artery disease. We propose to use magnetic resonance imaging (MRI) as an advanced, quantitative imaging modality to determine in short (20 minute) exams the myocardial perfusion reserve in a group of 400 MESA participants. We hypothesize that impaired myocardial perfusion reserve indicates the presence of subclinical coronary atherosclerosis and coronary microvascular disease. As CHD remains the leading cause of death in the U.S. there is strong interest in developing such new measures of subclinical disease which would provide an early opportunity for intervention and lifestyle modification to prevent CHD and/or congestive heart failure.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL065580-03
Application #
6527069
Study Section
Special Emphasis Panel (ZRG1-EDC-2 (03))
Program Officer
Bild, Diane
Project Start
2000-09-20
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2005-06-30
Support Year
3
Fiscal Year
2003
Total Cost
$322,824
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
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Shah, Ravi V; Abbasi, Siddique A; Heydari, Bobak et al. (2013) Insulin resistance, subclinical left ventricular remodeling, and the obesity paradox: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 61:1698-706
Laek, Babray; Szklo, Moyses; McClelland, Robyn L et al. (2013) The prospective association of Chlamydia pneumoniae and four other pathogens with development of coronary artery calcium: the multi-ethnic study of atherosclerosis (MESA). Atherosclerosis 230:268-74
Wong, Nathan D; Lopez, Victor A; Allison, Matthew et al. (2011) Abdominal aortic calcium and multi-site atherosclerosis: the Multiethnic Study of Atherosclerosis. Atherosclerosis 214:436-41
Li, Xin; Springer Jr, Charles S; Jerosch-Herold, Michael (2009) First-pass dynamic contrast-enhanced MRI with extravasating contrast reagent: evidence for human myocardial capillary recruitment in adenosine-induced hyperemia. NMR Biomed 22:148-57
Wang, Lu; Wong, Tien Y; Sharrett, A Richey et al. (2008) Relationship between retinal arteriolar narrowing and myocardial perfusion: multi-ethnic study of atherosclerosis. Hypertension 51:119-26
Milles, Julien; van der Geest, Rob J; Jerosch-Herold, Michael et al. (2008) Fully automated motion correction in first-pass myocardial perfusion MR image sequences. IEEE Trans Med Imaging 27:1611-21
Jerosch-Herold, Michael; Vazquez, Gabriela; Wang, Lu et al. (2008) Variability of myocardial blood flow measurements by magnetic resonance imaging in the multi-ethnic study of atherosclerosis. Invest Radiol 43:155-61
Milles, J; van der Geest, R J; Jerosch-Herold, M et al. (2007) Fully automated registration of first-pass myocardial perfusion MRI using independent component analysis. Inf Process Med Imaging 20:544-55
Rosen, Boaz D; Lima, Joao A C; Nasir, Khurram et al. (2006) Lower myocardial perfusion reserve is associated with decreased regional left ventricular function in asymptomatic participants of the multi-ethnic study of atherosclerosis. Circulation 114:289-97

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