Rationale and design of Dongzong CArdIovascuLar Bio-imaging RegistrY (DAILY) study: Bridging multiomics, imaging and cardiovascular disease

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  Central Illustration, A, The participants in DAILY study were recruited from a clinical referral population with cardiac CT indications. B, The study database comprises exposure information collected via questionnaires, CT imaging (including CAC, CCTA, and chest CT), biological specimens (saliva and blood samples), as well as follow-up health data. C, Exposures factors and genetic predisposition interact to influence downstream alterations in proteins, metabolites, and the microbe, thereby driving changes in a series of intermediate phenotypes represented by imaging characteristics, primary endpoints included MACE and new-onset diseases. D, The findings of this study are intended to be translated into specific new biomarkers, improved risk stratification, drug development, and artificial intelligence development and applications, ultimately enabling personalized precision-medicine strategies for disease management. DAILY = Dongzong CArdIovascuLar Bio-imaging RegistrY Study; CT = computed tomography; CAC = coronary artery calcification; CCTA = coronary CT angiography; MACE = major adverse cardiovascular events.

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  Fig. 1. Schematic diagram of the research framework and procedures for the bioimaging database. DAILY = Dongzong CArdIovascuLar Bio-imaging RegistrY Study; CT = computed tomography; CAC= coronary artery calcification; CCTA = coronary CT angiography; CT-FFR = CT derived fractional flow reserve; FAI = fat attenuation index; MACE = major adverse cardiovascular events.

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  Fig. 2. Participant enrollment. As of September 10, 2025, the enrollment process for 8699 participants in this study has been completed. CT = computed tomography.

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  Fig. 3. Questionnaires survey. The questionnaire completion rate at the time of visit among the 8699 participants in the study. PSQI = Pittsburgh sleep quality index; EQ-5D-5 L = EuroQoL 5-Dimension 5-Level; GAD-7 = generalized anxiety disorder-7; SCD = subjective cognitive decline.

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  Fig. 4. Rate of adequate imaging and biospecimen. Adequate plasma (98.3%, 8547/8699, absent = 67, unacceptable = 85), buffy coat (98.3%, 8547/8699, absent = 67, unacceptable = 85), serum (97.0%, 8439/8699, absent = 67, unacceptable = 193) and saliva (99.1%, 8612/8699, absent = 87) sampling quality was acquired, while the adequate image quality of 99.1% (8618/8699, 1 point = 81), 99.6% (8662/8699, 1 point = 37), and 99.7% (5563/5582, 1 point = 19) for CCTA, CAC and chest CT. CCTA = coronary CT angiography; CAC = coronary artery calcification; CT = computed tomography.