Aortic arch haemodynamics in adult women with Turner syndrome: A numerical investigation into obesity-related factors
Lead Research Organisation:
University of Strathclyde
Department Name: Biomedical Engineering
Abstract
EPSRC : Lauren Johnston : EP/R513349/1
Girls with Turner syndrome (TS), a chromosomal condition in which a female has complete or partial absence of the second sex chromosome, present a unique group of patients, with an increased risk of cardiovascular disease. Mortality rates are three times higher in TS women compared with the general population, and life expectancy is reduced by up to 13 years - the most common cause of death being from cardiovascular disease. Children with TS also have a greater underlying predisposition to obesity, which is found to increase with age. Since the mid 1900s extensive research has led to advancements in the treatment of Turner syndrome: growth hormone therapy can increase final adult height, and reproductive treatment can assist with infertility. However, cardiovascular diseases affecting girls and women with TS remain under-researched, and remains the leading cause of death. Our research aims to contribute to one of the key cardiovascular research priorities outlined in a scientific statement from the American Heart Association, which is to elucidate the pathogenesis of increased cardiovascular morbidity and mortality in women with TS compared with the general population and determine the contributions of atherosclerotic disease, hypertension, and obesity.
The proposed project will increase our understanding of the haemodynamic environment and, ultimately, flow-related cardiovascular disease markers in patients with Turner syndrome by reconstructing 3D models of the aorta and performing blood flow simulations, using computational fluid dynamic methods. Current research in the UK has highlighted some aspects of the aortic haemodynamics in children with Turner syndrome. The project proposed for the Mitacs Globalink placement complements the scope of this research by addressing questions relating to the adult Turner syndrome population. Without the proposed new collaboration between the UK and Canadian research groups, the student would not be able to extend the study cohort to adult TS patients. The research carried out at the University of Strathclyde combined with the prospective research to be carried out at the University of Toronto will provide the first ever analysis of blood flow in both paediatric and adult Turner syndrome patients. The project is highly multi-disciplinary within the broad fields of Biomedical Engineering, Fluid Mechanics, and Paediatric Medicine, and in close collaboration with clinicians at both Scottish and Canadian hospitals. This research could have an immeasurable impact for Turner syndrome patients in both the UK and Canada, improving significantly their personalised care and quality of life.
Girls with Turner syndrome (TS), a chromosomal condition in which a female has complete or partial absence of the second sex chromosome, present a unique group of patients, with an increased risk of cardiovascular disease. Mortality rates are three times higher in TS women compared with the general population, and life expectancy is reduced by up to 13 years - the most common cause of death being from cardiovascular disease. Children with TS also have a greater underlying predisposition to obesity, which is found to increase with age. Since the mid 1900s extensive research has led to advancements in the treatment of Turner syndrome: growth hormone therapy can increase final adult height, and reproductive treatment can assist with infertility. However, cardiovascular diseases affecting girls and women with TS remain under-researched, and remains the leading cause of death. Our research aims to contribute to one of the key cardiovascular research priorities outlined in a scientific statement from the American Heart Association, which is to elucidate the pathogenesis of increased cardiovascular morbidity and mortality in women with TS compared with the general population and determine the contributions of atherosclerotic disease, hypertension, and obesity.
The proposed project will increase our understanding of the haemodynamic environment and, ultimately, flow-related cardiovascular disease markers in patients with Turner syndrome by reconstructing 3D models of the aorta and performing blood flow simulations, using computational fluid dynamic methods. Current research in the UK has highlighted some aspects of the aortic haemodynamics in children with Turner syndrome. The project proposed for the Mitacs Globalink placement complements the scope of this research by addressing questions relating to the adult Turner syndrome population. Without the proposed new collaboration between the UK and Canadian research groups, the student would not be able to extend the study cohort to adult TS patients. The research carried out at the University of Strathclyde combined with the prospective research to be carried out at the University of Toronto will provide the first ever analysis of blood flow in both paediatric and adult Turner syndrome patients. The project is highly multi-disciplinary within the broad fields of Biomedical Engineering, Fluid Mechanics, and Paediatric Medicine, and in close collaboration with clinicians at both Scottish and Canadian hospitals. This research could have an immeasurable impact for Turner syndrome patients in both the UK and Canada, improving significantly their personalised care and quality of life.
Description | Due to COVID, current research has focused on children with Turner Syndrome with a full haemodynamic analysis. We hope to extend this research to adult women with TS. |
Exploitation Route | The clinical relevance of the research so far relates to children with Turner syndrome. |
Sectors | Healthcare |
Title | Computational models of Turner syndrome aorta |
Description | Retrospective cardiac MRI data for paediatric Turner syndrome patients was obtained through our collaboration with the Queen Elizabeth University Hospital. From these MRI images, three-dimensional computational models were created of the aortic arch for a small (n<10) patient group. With the recruitment of more patients, this database of Turner syndrome models will be expanded on. |
Type Of Material | Computer model/algorithm |
Year Produced | 2020 |
Provided To Others? | No |
Impact | The development of computational Turner syndrome aorta models was used to simulate the patient-specific blood flow and the haemodynamic results were analysed and are in the process of being published. |
Description | Collaboration with Queen Elizabeth University Hospital |
Organisation | Queen Elizabeth University Hospital |
Country | United Kingdom |
Sector | Hospitals |
PI Contribution | We have provided our partners at the hospital with our expertise in computational fluid dynamics, and the processing of patient data using these methods to reveal interesting results which we are in the process of joint publishing. |
Collaborator Contribution | Throughout this collaboration with both the Department of Radiology and the Department of Paediatric Endocrinology at Royal Hospital for Children, Queen Elizabeth University Hospital (Glasgow, UK), our partners have provided us with anonymous retrospective patient data, and their clinical expertise. |
Impact | A joint publication is in the process and will be submitted early 2021. This collaboration is multi-disciplinary as it includes the Department of Paediatric Endocrinology, as the patient group we are interested in are children with Turner syndrome, the Department of Cardiology, as we are studying the cardiovascular health of these patients, and the the Department of Radiology, as the patient data we obtain is cardiac MRI data. |
Start Year | 2018 |
Description | Cardiovascular Journal Club (Queen Elizabeth University Hospital) presentation |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Virtual oral presentation to the cardiovascular practitioners at the Queen Elizabeth University Hospital. |
Year(s) Of Engagement Activity | 2020 |
Description | Endocrinology Journal Club (Queen Elizabeth University Hospital) presentation |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Professional Practitioners |
Results and Impact | Oral presentation to the Endocrinology doctors at the Queen Elizabeth University Hospital. |
Year(s) Of Engagement Activity | 2020 |
Description | Meet the Researcher Showcase Event |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Schools |
Results and Impact | Exhibit hosted at the "Meet the Researcher Showcase" event, Dundee Science centre, for school children. Event hosted by Medical Research Scotland. |
Year(s) Of Engagement Activity | 2020 |
Description | Science Communication (primary school) volunteering |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Schools |
Results and Impact | Volunteering in science commincation at a local primary school. In partnership with the University of Glasgow, Undergraduate Medical School. |
Year(s) Of Engagement Activity | 2020 |
Description | The Scottish Cardiovascular Forum presentation |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Poster presentation at the Scottish Cardiovascular Forum meeting hosted by SIPBS, University of Strathclyde. |
Year(s) Of Engagement Activity | 2020 |
Description | World Congress in Computational Mechanics (WCCM) presentation |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | Virtual oral presentation and live panel participation (titled "Computational mechanics in pediatric medicine"), at the annual WCCM conference with 3000+ participants. |
Year(s) Of Engagement Activity | 2020 |