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New Insights from Major Prospective Cohort Studies with Cardiovascular Magnetic Resonance (CMR).

Arai AE - Curr Cardiol Rep (2015)

Bottom Line: The decade of follow-up enabled prognosis studies, an important step beyond association studies.In the MESA Study, coronary artery calcium was a better predictor of coronary artery disease end points than the non-contrast-enhanced MRI scan.In the ICELAND MI substudy of the AGES-Reykjavik Study, a contrast-enhanced MRI scan detected many more unrecognized myocardial infarctions (MIs) (UMIs) than detected by electrocardiography and documented these UMI had adverse prognostic significance.

View Article: PubMed Central - PubMed

Affiliation: National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services, Bldg 10, Rm B1D416, MSC 1061, 10 Center Drive, Bethesda, MD, 20892-1061, USA, araia@nih.gov.

ABSTRACT
Since 1948, epidemiology studies played an important role in understanding cardiovascular disease and afforded an opportunity to learn about newer diagnostic tests. In 2000, the MESA Study incorporated several advanced cardiovascular imaging modalities including cardiac magnetic resonance imaging (MRI) and coronary artery calcium scans. The decade of follow-up enabled prognosis studies, an important step beyond association studies. In brief, left ventricular hypertrophy by cardiac MRI predicted incident heart failure and stroke. In the MESA Study, coronary artery calcium was a better predictor of coronary artery disease end points than the non-contrast-enhanced MRI scan. In the ICELAND MI substudy of the AGES-Reykjavik Study, a contrast-enhanced MRI scan detected many more unrecognized myocardial infarctions (MIs) (UMIs) than detected by electrocardiography and documented these UMI had adverse prognostic significance. Thus, cardiac MRI has been successfully incorporated into large population studies and shown added value over conventional measurements of cardiovascular disease.

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Epidemiology studies can have substudies that parallel and complement other levels of clinical trials. These types of human studies can be done at a wide range of complexity, design, control, and regulation. Exploratory studies within an epidemiology study represent the equivalent of pilot studies. Examples of association studies and prognosis studies are discussed extensively in this article
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Fig1: Epidemiology studies can have substudies that parallel and complement other levels of clinical trials. These types of human studies can be done at a wide range of complexity, design, control, and regulation. Exploratory studies within an epidemiology study represent the equivalent of pilot studies. Examples of association studies and prognosis studies are discussed extensively in this article

Mentions: Epidemiology studies are one of many clinically relevant research methods that can help us understand the natural history of disease and gain new insights about diagnostic procedures. Epidemiology studies may provide insights to human disease at many different levels that parallel other types of clinical studies (Fig. 1). Associations between observations and disease-related characteristics represent the most common level of information in epidemiology studies. When enough subjects are followed to development of clinical outcomes, one can discuss conclusions regarding prognosis of subjects, a method used to define landmark findings such as the Framingham Risk Score. However, there is an implicit indirectness between causation and either associations or prognosis. On the other hand, prognosis studies generally are a stronger level of evidence between a characteristic and the eventual disease outcome. One of the purposes of this review will be to discuss association studies and outcome studies from within the same cohort.Fig. 1


New Insights from Major Prospective Cohort Studies with Cardiovascular Magnetic Resonance (CMR).

Arai AE - Curr Cardiol Rep (2015)

Epidemiology studies can have substudies that parallel and complement other levels of clinical trials. These types of human studies can be done at a wide range of complexity, design, control, and regulation. Exploratory studies within an epidemiology study represent the equivalent of pilot studies. Examples of association studies and prognosis studies are discussed extensively in this article
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4419187&req=5

Fig1: Epidemiology studies can have substudies that parallel and complement other levels of clinical trials. These types of human studies can be done at a wide range of complexity, design, control, and regulation. Exploratory studies within an epidemiology study represent the equivalent of pilot studies. Examples of association studies and prognosis studies are discussed extensively in this article
Mentions: Epidemiology studies are one of many clinically relevant research methods that can help us understand the natural history of disease and gain new insights about diagnostic procedures. Epidemiology studies may provide insights to human disease at many different levels that parallel other types of clinical studies (Fig. 1). Associations between observations and disease-related characteristics represent the most common level of information in epidemiology studies. When enough subjects are followed to development of clinical outcomes, one can discuss conclusions regarding prognosis of subjects, a method used to define landmark findings such as the Framingham Risk Score. However, there is an implicit indirectness between causation and either associations or prognosis. On the other hand, prognosis studies generally are a stronger level of evidence between a characteristic and the eventual disease outcome. One of the purposes of this review will be to discuss association studies and outcome studies from within the same cohort.Fig. 1

Bottom Line: The decade of follow-up enabled prognosis studies, an important step beyond association studies.In the MESA Study, coronary artery calcium was a better predictor of coronary artery disease end points than the non-contrast-enhanced MRI scan.In the ICELAND MI substudy of the AGES-Reykjavik Study, a contrast-enhanced MRI scan detected many more unrecognized myocardial infarctions (MIs) (UMIs) than detected by electrocardiography and documented these UMI had adverse prognostic significance.

View Article: PubMed Central - PubMed

Affiliation: National Heart, Lung and Blood Institute, National Institutes of Health, US Department of Health and Human Services, Bldg 10, Rm B1D416, MSC 1061, 10 Center Drive, Bethesda, MD, 20892-1061, USA, araia@nih.gov.

ABSTRACT
Since 1948, epidemiology studies played an important role in understanding cardiovascular disease and afforded an opportunity to learn about newer diagnostic tests. In 2000, the MESA Study incorporated several advanced cardiovascular imaging modalities including cardiac magnetic resonance imaging (MRI) and coronary artery calcium scans. The decade of follow-up enabled prognosis studies, an important step beyond association studies. In brief, left ventricular hypertrophy by cardiac MRI predicted incident heart failure and stroke. In the MESA Study, coronary artery calcium was a better predictor of coronary artery disease end points than the non-contrast-enhanced MRI scan. In the ICELAND MI substudy of the AGES-Reykjavik Study, a contrast-enhanced MRI scan detected many more unrecognized myocardial infarctions (MIs) (UMIs) than detected by electrocardiography and documented these UMI had adverse prognostic significance. Thus, cardiac MRI has been successfully incorporated into large population studies and shown added value over conventional measurements of cardiovascular disease.

Show MeSH
Related in: MedlinePlus