MultiMorbidity Life-Course Approach To Myocardial Health -A Cardiac Sub-Study of the MRC National Survey of Health and Development (NSHD)

Study Overview
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Brief Summary
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Background The life course accumulation of overt and subclinical myocardial dysfunction contributes to older age mortality, frailty, disability and loss of independence. The Medical Research Council National Survey of Health and Development (NSHD) is the world's longest running continued surveillance birth cohort providing a unique opportunity to understand life course determinants of myocardial dysfunction as part of MyoFit46-the cardiac sub-study of the NSHD. Methods and expected results The investigators aim to recruit 550 NSHD participants of approximately 75 years+ to undertake high-density surface electrocardiographic imaging (ECGI) and stress perfusion cardiovascular magnetic resonance (CMR). Through comprehensive myocardial tissue characterization and 4-dimensional flow the investigators hope to better understand the burden of clinical and subclinical cardiovascular disease. Supercomputers will be used to combine the multi-scale ECGI and CMR datasets per participant. Rarely available, prospectively collected whole-of-life data on exposures, traditional risk factors and multimorbidity will be studied to identify risk trajectories, critical change periods, mediators and cumulative impacts on the myocardium. Conclusion By combining well curated, prospectively acquired longitudinal data of the NSHD with novel CMR-ECGI data and sharing these results and associated pipelines with the CMR community, MyoFit46 seeks to transform our understanding of how early, mid and later-life risk factor trajectories interact to determine the state of cardiovascular health in older age.

Official Title
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A Cardiac Sub-Study of the MRC National Survey of Health and Development (NSHD)

Conditions
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Frailty, Cardiovascular Diseases

Intervention / Treatment
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* Diagnostic Test: CMR CGI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: NSHD study member. Who is still alive and agreed to take part in the study. Exclusion Criteria: Pacemaker. Implantable cardio defibrillator. Atrial fibrillation. Complete heart block. Severe asthma.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: CMR CGI|High resolution ECGI plus advanced CMR|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CMR phenotype - T1 | This will be assessed through a 45 minute cardiac MRI scan with perfusion. | Through study completion, an average of 4 years. | 
| CMR phenotype - T2 | This will be assessed through a 45 minute cardiac MRI scan with perfusion. | Through study completion, an average of 4 years. | 
| CMR phenotype - Myocardial blood flow | This will be assessed through a 45 minute cardiac MRI scan with perfusion. | Through study completion, an average of 4 years. | 
| CMR phenotype - Aortic blood flow | This will be assessed through a 45 minute cardiac MRI scan with perfusion. | Through study completion, an average of 4 years. |