Imaging and Omics for Cardiovascular Risk During NASA Deep Space Missions

The purpose of this study is to develop new approaches for screening astronauts for
cardiovascular risk during deep space missions. In this protocol, two different forms of
imaging will be used to evaluate coronary plaque development (CT coronary angiography) and
microvascular function (myocardial contrast echocardiography) to stratify CV risk. Based on
this stratification, "omic" patterns (targeted metabolomics, lipidomic, and whole genome
sequencing) will be assessed to determine whether there are any patterns that can add to
existing predictive models. Outcomes measures will involve correlation of "omic" patterns to
incremental risk scaling from lowest (no plaque and normal endothelial function) to highest
(+ plaque and endothelial dysfunction).

Inclusion Criteria:

- Patients referred for clinically indicated CT coronary angiography within 6 months

- No obstructive coronary plaque and an Agatston score of 0 or At least one obstructive
coronary plaque <50% diameter and one other high risk feature on CT-A (positive
remodeling, scattered calcification, low Hounsfield units, or "napkin ring" sign.

Exclusion Criteria:

- Known CAD or other atherosclerotic disease

- Valvular heart disease (moderate or more) and congenital heart disease

- Heart failure

- Pregnancy

- Allergy to ultrasound contrast agent.

- Right to left shunt