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Assessment of the stiffness of the aortic wall by Pulse Wave Velocity to predict risk of thoracic aortic aneurysm among hypertensive patients: The T-watch study

   Institute of Life Course and Medical Sciences

About the Project

Thoracic Aortic Aneurysm (TAA) is a silent but lethal, disease, with 95% of TAAs being asymptomatic before an acute event, such as dissection or rupture, occurs. Usually TAA are detected during the course of tests performed for other medical reasons.

The way in which TAA patients are selected for surgery is based on how much the aorta has bulged. Since 1997, an aortic diameter of 5.5 cm has been used widely as the threshold at which repair should be carried out. Current guidelines still refer to this cut-off size for TAA repair. However, there is evidence that the risk of rupture and death increases significantly at an earlier point of size (5.25 cm). For some aneurysms the growth rate may be about 1 mm each year. This slow, incremental growth falls within the margin of reproducibility error for computed tomography (CT) or Magnetic Resonance (MRI) image analysis; as a result, it may represent an insensitive parameter for knowing whether a patient is at risk of a burst aorta.

Take together these findings outline the need for having a screening tool to assess vulnerable aorta among the general populations and to move away from reliance on ‘aortic size’ for knowing if a patient is at risk and likely to rupture. This will be based on developing a relationship between early vascular aging (EVA) and tissue level changes in the structural and mechanical properties in the aneurysmal aorta as part of the translational pathway of this proposal.

Specific objectives of this PhD:

  1. To assess in vivo aortic stiffness with Pulse Wave Velocity with applanation tonometry in wide spectrum of population with thoracic aortic aneurysm and systemic hypertension. This will use a small, handheld device, the PulsePen® ETT® (DiaTecne).
  2. To characterise structural, biochemical and biomechanical properties of aortic tissue in those requiring aortic elective surgery. Such nanomechanical-histopathological tissue assessment will be performed following elective surgery.

The PhD project includes a diverse method which will be finalized according to applicant interests and expertise. Training in the specific technique will be provided.

Funding note: This project is offered to self-funded PhD candidates with a background in biology or related fields, or a health-related subject. Competence in data analysis would be highly desirable

PhD training:

All postgraduate students undertake the PGR Development Programme which aims to enhance their skills for a successful research experience and career. They are required to maintain an online record of their progress and record their personal and professional development throughout their research degree. In addition to monthly supervision meetings, The Liverpool Centre for Cardiovascular Science holds monthly group research meetings where students are given opportunities to present their research. The PhD student will receive training from clinical and academic experts in appropriate methodologies, including conducting systematic reviews, data analysis, academic writing, and applying for ethics approval to conduct clinical research. The Institute of Life Course and Medical Science is fully committed to promoting gender equality in all activities. In recruitment we emphasize the supportive nature of the working environment and the flexible family support that the University provides. The Institute holds a silver Athena SWAN award in recognition of on-going commitment to ensuring that the Athena SWAN principles are embedded in its activities and strategic initiatives. 



R Proietti, Gregory Y.H. Lip, Riaz Akhtar, and Mark Field. Thoracic aortic aneurysms and atrial fibrillation: commonality in pathophysiological pathways. Cardiovascular Research (2022) 118, e32–e35
R Vio , A S. Giordani, M Stefil, J Madine,, T Fairbairn
S Themistoclakisa, P Salvi, A Caforiob, A Shantsila, E Shantsila, R. Akhtar, Mark Field, Gregory Y.H. Lip, and R Proietti. Arterial stiffness and atrial fibrillation: shared mechanisms, clinical implications and
therapeutic options. Journal of Hypertension (2022) in press

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